Guilt as an Influencer in End-of-Life Care Decisions for Nursing Home Residents With Advanced Dementia.
Ashley Roach, Anita H Rogers, Meghan Hendricksen and 3 others
PMID 34978495WHAT IT FOUND
Nursing home staff believed guilt drove proxies to choose aggressive end-of-life care.
Proxies did not describe guilt in those decisions; they called decision making difficult, a privilege, and a job.
Key findings
01Staff reported that proxies who felt guilty tended to choose more aggressive care, but no proxies mentioned guilt as influencing their end-of-life decisions.
02Proxies described their role as decision makers as being difficult, a privilege, and a job.
03Staff linked proxy guilt to past relationship problems and to not visiting or understanding the resident's decline.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Participants were not asked directly about guilt, so proxies may not have considered or acknowledged underlying feelings. The study did not consider regional and racial differences, which could affect how guilt is understood. It looked only at proxies of residents already in late-stage dementia, so it does not speak to earlier decision making. It reports perceptions, not observed treatment choices, so it cannot show that guilt caused aggressive care.
Declared interests
The authors disclosed no potential conflicts of interest, financial or otherwise.
The easy way to misread this
Do not conclude that guilt causes proxies to choose aggressive end-of-life care. Staff believed this, but no proxies mentioned guilt, and participants were not asked directly about guilt.