Journal of palliative medicine
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Few studies have examined proxy decision-making regarding end-of-life treatment decisions. Proxy accuracy is defined as whether proxy treatment choices are consistent with the expressed wishes of their index elder. The purpose of this study was to examine proxy accuracy in relation to two family factors that may influence proxy accuracy: perceived family conflict and type of elder-proxy relationship. ⋯ Spousal proxies were more accurate in their substituted judgment than adult children, and proxies who perceive higher degree of family conflict tended to be less accurate than those with lower family conflict. Health care providers should be aware of these family factors when discussing advance care planning.
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There has recently been a call for an analysis of the way in which professionals see their role and status in the context of palliative care and the interdisciplinary team. This is particularly salient in the provision of psychosocial care. ⋯ Two major themes emerged from our research: "Lack of clear role boundaries" and "Strategies for maintenance of role boundaries," which included: "Claiming access to specialist expertise and knowledge" and "Minimizing the knowledge of other professions and professionals." It is argued that effective team functioning can be enhanced through the development of interdisciplinary team training programs and policies, resources and structures that provide support for the interdisciplinary team model.