title: Intellectual Disabilities and Decision Making at End of Life: A Literature Review.
abstract: BACKGROUND
  Individuals with an intellectual disability are vulnerable to having end-of-life decisions made for them merely due to the presence of a disability. As a result, decisions made by others may not reflect the exact wishes of the individual.
  
  
  METHODS
  This review examines literature on individuals with an intellectual disability in making end-of-life decisions from the years 2000 to 2014. A total of 38 articles were found with 12 articles having a direct focus on end-of-life decision making.
  
  
  RESULTS
  The emerging themes include the following: (i) assumption of lack of capacity, (ii) inconsistency in evaluating capacity and communication challenges and (iii) third party decisions.
  
  
  CONCLUSIONS
  Earlier discussions about end-of-life planning before the diagnosis of a life-limiting illness would be beneficial. Lacking is a consistent approach to determining capacity for individuals with an intellectual disability. The findings from this review provide a foundation for a decision tree in end-of-life decision making for individuals with an intellectual disability.
authors.affiliation: Greenspun College of Urban Affairs, School of Social Work, University of Nevada at Las Vegas, Las Vegas, NV, USA.
authors.forename: Abbie
authors.initials: A
authors.lastname: Kirkendall
authors.affiliation: Health Sciences Program, California State University, Channel Islands, Camarillo, CA, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Linton
authors.affiliation: Beacon Pointe, 2810 W. Charleston Blvd., Las Vegas, NV, 89102.
authors.forename: Saritha
authors.initials: S
authors.lastname: Farris
mesh_terms: D003142:Communication; D003657:Decision Making; D006233:Persons with Disabilities; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D010358:Patient Participation; D013727:Terminal Care / Q000523:psychology*
keywords: barriers; capacity; decision making; end-of-life; informed consent; intellectual disability