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The Hands of Time.

Ariane Lewis1

  • 1NYU Langone Medical Center, New York, NY, USA.

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Summary
This summary is machine-generated.

Family disagreements complicate end-of-life care decisions for incapacitated patients. This case study explores navigating these complex family dynamics during goals-of-care discussions after a catastrophic stroke.

Keywords:
comfort carecommunicationend-of-lifefamilygoals-of-carestroke

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Area of Science:

  • Medical Ethics
  • Neurology
  • Family Medicine

Background:

  • Goals-of-care decisions for incapacitated patients often involve surrogates.
  • Complex family dynamics and pre-existing discord can complicate these decisions.
  • Catastrophic strokes necessitate critical end-of-life care planning.

Purpose of the Study:

  • To describe the evolution of end-of-life discussions.
  • To illustrate challenges in surrogate decision-making with discordant families.
  • To highlight strategies for managing complex family dynamics in critical care.

Main Methods:

  • Case study methodology.
  • Retrospective analysis of end-of-life discussions.
  • Qualitative description of family interactions.

Main Results:

  • Internal surrogate disagreements arose due to pre-existing family discord.
  • Navigating complex family dynamics was central to the decision-making process.
  • Effective communication strategies were crucial for facilitating discussions.

Conclusions:

  • Family discord significantly impacts goals-of-care discussions for incapacitated patients.
  • Addressing family dynamics is essential for ethical and effective surrogate decision-making.
  • Case studies offer valuable insights into managing complex end-of-life scenarios.