Abstract：
OBJECTIVES:To determine the role terminally ill patients would opt to have their loved ones and physicians play in healthcare decisions should they lose decision-making capacity and how this changes over time. DESIGN:Serial interviews. SETTING:The study institutions were The Johns Hopkins Medical Institutions in Baltimore, Maryland, and St. Vincent's Hospital, in New York. PARTICIPANTS:One hundred forty-seven patients with cancer, amyotrophic lateral sclerosis, or heart failure, at baseline and 3 and 6 months. RESULTS:Patients' baseline decision control preferences varied widely, but most opted for shared decision-making, leaning slightly toward independence from their loved ones. This did not change significantly at 3 or 6 months. Fifty-seven percent opted for the same degree of decision control at 3 months as at baseline. In a generalized estimating equation model adjusted for time, more-independent decision-making was associated with college education (P=.046) and being female (P=.01), whereas more-reliant decision-making was associated with age (P<.001). Patients leaned toward more reliance upon physicians to make best-interest determinations at diagnosis but opted for physicians to decide based upon their own independent wishes (substituted judgment) over time, especially if college educated. CONCLUSION:Terminally ill patients vary in how much they wish their own preferences to control decisions made on their behalf, but most would opt for shared decision-making with loved ones and physicians. Control preferences are stable over time with respect to loved ones, but as they live longer with their illnesses, patients prefer somewhat less reliance upon physicians.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Sulmasy DP,Hughes MT,Thompson RE,Astrow AB,Terry PB,Kub J,Nolan MTdoi
10.1111/j.1532-5415.2007.01473.xsubject
Has Abstractpub_date
2007-12-01 00:00:00pages
1981-8issue
12eissn
0002-8614issn
1532-5415pii
JGS1473journal_volume
55pub_type
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,随机对照试验
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.1993.tb06452.x
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更新日期：2006-06-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/jgs.15939
更新日期：2019-05-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1980.tb00515.x
更新日期：1980-04-01 00:00:00
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doi：10.1111/j.1532-5415.2004.52273.x
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abstract：OBJECTIVE:To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors. DESIGN:Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA). SETTING:Nati...
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更新日期：2001-07-01 00:00:00
abstract：OBJECTIVES:Many elderly persons have drug benefits with coverage gaps, such as in Medicare Part D. Because beneficiaries who have such gaps must pay all drug costs, an accurate knowledge of gap thresholds and communication with providers about exceeding caps is important for elderly persons to manage out-of-pocket drug...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2009.02244.x
更新日期：2009-05-01 00:00:00
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doi：10.1046/j.1365-2389.2003.51303.x
更新日期：2003-07-01 00:00:00
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pub_type： 杂志文章,随机对照试验
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更新日期：2017-03-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/jgs.15203
更新日期：2018-02-01 00:00:00
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pub_type： 杂志文章
doi：10.1111/j.1532-5415.1992.tb01831.x
更新日期：1992-01-01 00:00:00
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更新日期：2018-08-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1993.tb06177.x
更新日期：1993-08-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1994.tb06599.x
更新日期：1994-09-01 00:00:00
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doi：10.1111/j.1532-5415.1992.tb02073.x
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journal_title：Journal of the American Geriatrics Society
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doi：10.1111/j.1532-5415.1985.tb02855.x
更新日期：1985-01-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
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更新日期：1999-07-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1990.tb03477.x
更新日期：1990-02-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
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更新日期：2004-11-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.2007.01205.x
更新日期：2007-08-01 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
doi：10.1111/j.1532-5415.1978.tb01958.x
更新日期：1978-05-01 00:00:00
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pub_type： 杂志文章
doi：10.1111/jgs.17006
更新日期：2020-12-31 00:00:00
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journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章
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更新日期：2000-05-01 00:00:00
abstract：:The characteristic morphologic changes frequently observed in the brain of an old adult include a decrease in weight and volume, a change in the pattern of cerebral cortical convolutions, and an increase in ventricular size. Cell loss varies from region to region in the brain, and may be intensified in Alzheimer's dis...
journal_title：Journal of the American Geriatrics Society
pub_type： 杂志文章,评审
doi：10.1111/j.1532-5415.1976.tb03246.x
更新日期：1976-01-01 00:00:00
