Related Experiment Video
Updated: Sep 11, 2025
Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Surrogate Decision-Making Practices Regarding End-of-Life Care for People With Dementia in Long-Term Care Hospitals:
Hyejin Kim1, Jeonghyun Cho2, Jongsun Park1
1Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.
Aim:
To explore surrogate decision-making practices regarding end-of-life care for people with dementia in Korean long-term care hospitals from the perspective of healthcare providers.
Design:
A qualitative descriptive study.
Methods:
The data were collected through individual semi-structured interviews with 24 healthcare providers (physicians, oriental medicine doctors, registered nurses and social workers) involved in dementia end-of-life care in their current long-term care hospitals in South Korea. The data were analysed using a conventional content analytic technique.
Results:
The analysis yielded three categories and nine subcategories describing surrogate decision-making practices regarding end-of-life care for people with dementia: (a) typical circumstances of end-of-life care planning, (b) expected roles of key personnel and related challenges and (c) important considerations. Participants discussed available treatment options within long-term care hospitals and the potential transfers to acute care hospitals during admission and periods of health decline. Physicians typically led such end-of-life care planning, with nurses playing a supportive role and family members making the final decisions. However, they faced challenges in performing their roles. In end-of-life care discussions, participants weighed the patients' autonomy and best interests alongside family members' interests and other external concerns such as potential lawsuits and insufficient medical resources.
Conclusion:
Surrogate decision-making regarding end-of-life care in the context of dementia within long-term care hospitals is considerably complex and challenging for healthcare providers, requiring multifaceted institution-sensitive support.
Implications For The Profession And/Or Patient Care:
The study findings suggest the need for targeted education and training to enhance healthcare providers' competencies in end-of-life care discussions, advance care planning and the development of policies and regulations supporting end-of-life care-related practices within long-term care hospitals.
Reporting Method:
This study was reported in accordance with the COREQ checklist.
Patient Or Public Contribution:
No patient or public contribution.
Related Concept Videos
01:30Ethical Dilemmas II
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:19Standards of Care II
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:17Ethical Dilemmas I
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...