ArticleJournal of the American Geriatrics Society2021
Older Adults without Desired Surrogates in a Nationally Representative Sample.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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.
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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.
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Who cites it
5 citing papers in PubMed.
- American Geriatrics Society position statement: Making medical treatment decisions for unrepresented older adults.Journal of the American Geriatrics Society · 2025Article
- Article
- Current situation of the hospitalization of persons without family in Japan and related medical challenges.PloS one · 2023Article
- Characteristics of Older Adults Who Cannot Identify a Healthcare Agent.Journal of general internal medicine · 2022Article
- "I worry about this patient EVERY day": Geriatrics Clinicians' Challenges in Caring for Unrepresented Older Adults.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
BACKGROUND/
objectivesLittle is known about older adults who have intact capacity but do not have a desired surrogate to make decisions if their capacity becomes impaired.
designCross-sectional study of a nationally representative sample.
settingNational Social Life, Health, and Aging Project (NSHAP), 2005-2006.
participantsCommunity-dwelling older adults without known cognitive impairment, aged 57 to 85, interviewed as part of NSHAP (n = 2,767). MEASUREMENTS: We examined demographic, medical, and social connectedness characteristics associated with answering "no" to this question: "Do you have someone who you would like to make medical decisions for you if you were unable, as for example if you were seriously injured or very sick?" Because many states permit nuclear family to make decisions for persons with no legally appointed health care agent, we used logistic regression to identify factors associated with individuals who were ill suited to this paradigm in the sense that they had nuclear family but did not have a desired surrogate.
resultsAmong NSHAP respondents, 7.5% (95% confidence interval = 6.4-8.7) did not have a desired surrogate. Nearly 90% of respondents without desired surrogates had nuclear family. Compared with respondents with desired surrogates, those without desired surrogates had lower indicators of social connectedness. On average, however, they had four confidants, approximately 70% socialized at least monthly, and more than 90% could discuss their health with a confidant. Among respondents who had nuclear family, few characteristics distinguished those with and without desired surrogates.
conclusionNearly 8% of older adults did not have a desired surrogate. Most had nuclear family and were not socially disconnected. Older adults should be asked explicitly about a desired surrogate, and strategies are needed to identify surrogates for those who do not have family or would not choose family to make decisions for them.
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