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Updated: Jul 13, 2026

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Published on: December 18, 2013
The family surrogates' psychological experience of making a do-not-resuscitate decision for older relatives: a
Yi-Ping Tseng1,2, Lian-Hua Huang3,4, Li-Ling Hsu5,6
1a Medical College , National Taiwan University , Taipei , Taiwan.
Background:
Many nursing home residents lack autonomous decision-making capacity and rely on family members to make do-not-resuscitate (DNR) decisions. Making DNR decisions can be difficult and complicated for surrogates. However, surrogates' psychological experience in making these decisions for older relatives is not well studied.
Aim:
To understand the surrogates' psychological experience of making DNR decisions for older relatives in a nursing home.
Methods:
The study subjects of this qualitative study were family surrogates of older residents in a nursing home of Taiwan. A self-constructed, semi-structured interview guided in-depth interviews, which were recorded. Content analysis was used to discover themes from verbatim record.
Results:
Four themes were revealed: lack of psychological preparation, considering issues when making a decision, ambivalent emotional responses and impact of cultural factors. Fifteen subthemes were also found.
Conclusions:
Surrogates who must decide whether to make a DNR decision for older relatives experience great emotional conflict. Understanding surrogates' struggles may assist nursing and care staff in managing this difficult situation.
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