ArticleJournal of the American Geriatrics Society2018
Older Adult and Surrogate Perspectives on Serious, Difficult, and Important Medical Decisions.
Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review.BMC geriatrics · 2021Pooled it
- Perceptions of prognosis and end-of-life care outcomes in patients with advanced lung and gastrointestinal cancer.Palliative medicine · 2023Trial
- An Early Palliative Care Telehealth Coaching Intervention to Enhance Advanced Cancer Family Caregivers' Decision Support Skills: The CASCADE Pilot Factorial Trial.Journal of pain and symptom management · 2022Trial
- Asking Older Adults With Impaired Cognition and Care Partners About Serious Illness Experiences Can Elicit Goals of Care During Advance Care Planning.The American journal of hospice & palliative care · 2026Article
- Goals of Care Discussions in Medical Training: Integrating Palliative Care for Holistic, Patient-Centered Care.Healthcare (Basel, Switzerland) · 2026Review
- Truth-Telling to Palliative Care Patients from the Relatives' Point of View: A Türkiye Sample.Healthcare (Basel, Switzerland) · 2025Article
- "Nobody Can Be Equipped for This": Advice From New Residents of Long-Term Care Facilities.Journal of the American Geriatrics Society · 2025Article
- "Treat people with human dignity": the perspective of older adults on the quality of geriatric rehabilitation.European geriatric medicine · 2024Article
- Aging-in-place versus long-term care conflicts experienced by older adults.Journal of the American Geriatrics Society · 2024Article
- Article
- What matters most to older adults: Racial and ethnic considerations in values for current healthcare planning.Journal of the American Geriatrics Society · 2023Article
- Decision support training for advanced cancer family caregivers: Study protocol for the CASCADE factorial trial.Contemporary clinical trials · 2023Article
- Projection of Care Partners' Preferences in the Proxy Assessments of Everyday Preferences for Persons With Cognitive Impairment.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023Article
- Discussing Difficult News: Reframing Patient and Family Preferences Surrounding the Content and Style of Communication.Cancer treatment and research · 2023Article
- Surrogate Decision Makers Need Better Preparation for Their Role: Advice from Experienced Surrogates.Journal of palliative medicine · 2022Article
- Patient values in healthcare decision making among diverse older adults.Patient education and counseling · 2022Article
- Ethical challenges in family caregivers of patients with advanced cancer - a qualitative study.BMC palliative care · 2020Article
- Palliative Care for Parkinson Disease.Clinics in geriatric medicine · 2020Review
- How family caregivers of persons with advanced cancer assist with upstream healthcare decision-making: A qualitative study.PloS one · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo elicit decisions that diverse older adults and surrogates perceive as serious, difficult, or important and explore what helped them make those decisions.
designFocus groups (N=13) in which participants were asked to recall serious, difficult, or important medical decisions and what helped them make those decisions.
settingClinics, support groups and senior centers.
participantsDiverse English- and Spanish-speaking older adults (age: mean 78, range 64-89) and surrogates (age: mean 57, range 33-76) (29% African American, 26% white, 26% Asian or Pacific Islander, 19% Hispanic) (N=69). MEASUREMENTS: We used thematic analysis to analyze transcripts.
resultsWe identified 168 decisions. Older adults from all racial and ethnic groups frequently recalled cancer treatment decisions and decisions about chronic illness management. Surrogates described decisions about transitions in care and medical crises. Older adults valued self-sufficiency and maximizing survival and relied on personal experiences as often as medical advice. In all racial and ethnic groups, surrogates valued avoiding suffering for loved ones.
conclusionDiverse older adults and surrogates perceive life-threatening illness and day-to-day decisions about chronic disease to be serious, difficult, and important. The surrogates' goal of avoiding suffering of older adults may differ from older adults' priorities of self-sufficiency and maximizing survival. Clinicians should support older adults and surrogates in identifying important and difficult decisions and learn about the values and information sources they bring to decision-making. With this knowledge, clinicians can customize decision support and achieve person-centered care.
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