Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.
OBJECTIVE
The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care.


METHODS
This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined.


RESULTS
Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations.


CONCLUSIONS
The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.
Lambert
Heather C
HC
Centre for Health Services and Policy Research, Queen's University, Abramsky Hall, 3rd floor, Kingston, Ontario. hcl@post.queensu.ca
McColl
Mary Ann
MA
Gilbert
Julie
J
Wong
Jiahui
J
Murray
Gale
G
Shortt
Samuel E D
SE
D016223:Advance Directives / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003657:Decision Making; D005239:Fear; D005260:Female; D006287:Health Planning Guidelines; D006707:Homes for the Aged; D006801:Humans; D033181:Information Dissemination; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D012944:Social Support; D029181:Spirituality