Skip to main content
Top
Published in: Journal of Religion and Health 3/2016

01-06-2016 | Original Paper

Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults

Authors: Kristin N. Geros-Willfond, Steven S. Ivy, Kianna Montz, Sara E. Bohan, Alexia M. Torke

Published in: Journal of Religion and Health | Issue 3/2016

Login to get access

Abstract

We conducted semi-structured interviews with 46 surrogate decision makers for hospitalized older adults to characterize the role of spirituality and religion in decision making. Three themes emerged: (1) religion as a guide to decision making, (2) control, and (3) faith, death and dying. For religious surrogates, religion played a central role in end of life decisions. There was variability regarding whether God or humans were perceived to be in control; however, beliefs about control led to varying perspectives on acceptance of comfort-focused treatment. We conclude that clinicians should attend to religious considerations due to their impact on decision making.
Literature
go back to reference Abbott, K. H., Sago, J. G., Breen, C. M., Abernethy, A. P., & Tulsky, J. A. (2001). Families looking back: One year after discussion of withdrawal or withholding of life-sustaining support. Critical Care Medicine, 29(1), 197–201.CrossRefPubMed Abbott, K. H., Sago, J. G., Breen, C. M., Abernethy, A. P., & Tulsky, J. A. (2001). Families looking back: One year after discussion of withdrawal or withholding of life-sustaining support. Critical Care Medicine, 29(1), 197–201.CrossRefPubMed
go back to reference Balboni, T. A., Balboni, M., Enzinger, A. C., Gallivan, K., Paulk, M. E., Wright, A., & Prigerson, H. G. (2013). Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Internal Medicine, 173(12), 1109–1117. doi:10.1001/jamainternmed.2013.903.CrossRefPubMedPubMedCentral Balboni, T. A., Balboni, M., Enzinger, A. C., Gallivan, K., Paulk, M. E., Wright, A., & Prigerson, H. G. (2013). Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Internal Medicine, 173(12), 1109–1117. doi:10.​1001/​jamainternmed.​2013.​903.CrossRefPubMedPubMedCentral
go back to reference Balboni, T. A., Vanderwerker, L. C., Block, S. D., Paulk, M. E., Lathan, C. S., Peteet, J. R., & Prigerson, H. G. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25(5), 555–560. doi:10.1200/JCO.2006.07.9046.CrossRefPubMedPubMedCentral Balboni, T. A., Vanderwerker, L. C., Block, S. D., Paulk, M. E., Lathan, C. S., Peteet, J. R., & Prigerson, H. G. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25(5), 555–560. doi:10.​1200/​JCO.​2006.​07.​9046.CrossRefPubMedPubMedCentral
go back to reference Branch, W. T, Jr, Torke, A. M., & Brown-Haithco, R. C. (2006). The importance of spirituality in African-Americans’ end-of-life experience. Journal of General Internal Medicine, 21(11), 1203–1205.CrossRefPubMedPubMedCentral Branch, W. T, Jr, Torke, A. M., & Brown-Haithco, R. C. (2006). The importance of spirituality in African-Americans’ end-of-life experience. Journal of General Internal Medicine, 21(11), 1203–1205.CrossRefPubMedPubMedCentral
go back to reference Braun, U. K., Beyth, R. J., Ford, M. E., & McCullough, L. B. (2008). Voices of African American, Caucasian, and Hispanic surrogates on the burdens of end-of-life decision making. Journal of General Internal Medicine, 23(3), 267–274.CrossRefPubMedPubMedCentral Braun, U. K., Beyth, R. J., Ford, M. E., & McCullough, L. B. (2008). Voices of African American, Caucasian, and Hispanic surrogates on the burdens of end-of-life decision making. Journal of General Internal Medicine, 23(3), 267–274.CrossRefPubMedPubMedCentral
go back to reference Buchanan, A. E., & Brock, D. W. (1990). Deciding for others: The ethics of surrogate decision making. Cambridge: Cambridge University Press.CrossRef Buchanan, A. E., & Brock, D. W. (1990). Deciding for others: The ethics of surrogate decision making. Cambridge: Cambridge University Press.CrossRef
go back to reference Clarke, E. B., Curtis, J. R., Luce, J. M., Levy, M., Danis, M., Nelson, J., & Solomon, M. Z. (2003). Quality indicators for end-of-life care in the intensive care unit. Critical Care Medicine, 31, 2255–2262.CrossRefPubMed Clarke, E. B., Curtis, J. R., Luce, J. M., Levy, M., Danis, M., Nelson, J., & Solomon, M. Z. (2003). Quality indicators for end-of-life care in the intensive care unit. Critical Care Medicine, 31, 2255–2262.CrossRefPubMed
go back to reference Crawley, L., Payne, R., Bolden, J., Payne, T., Washington, P., & Williams, S. (2000). Palliative and end-of-life care in the African American community. JAMA, 284(19), 2518–2521.CrossRefPubMed Crawley, L., Payne, R., Bolden, J., Payne, T., Washington, P., & Williams, S. (2000). Palliative and end-of-life care in the African American community. JAMA, 284(19), 2518–2521.CrossRefPubMed
go back to reference Davidson, J. E., Powers, K., Hedayat, K. M., Tieszen, M., Kon, A. A., Shepard, E., & Armstrong, D. (2007). Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Critical Care Medicine, 35(2), 605–622. doi:10.1097/01.CCM.0000254067.14607.EB.CrossRefPubMed Davidson, J. E., Powers, K., Hedayat, K. M., Tieszen, M., Kon, A. A., Shepard, E., & Armstrong, D. (2007). Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Critical Care Medicine, 35(2), 605–622. doi:10.​1097/​01.​CCM.​0000254067.​14607.​EB.CrossRefPubMed
go back to reference Elliott, B. A., Gessert, C. E., & Peden-McAlpine, C. (2007). Decision making by families of older adults with advanced cognitive impairment: Spirituality and meaning. Journal of Gerontological Nursing, 33, 49–55.PubMed Elliott, B. A., Gessert, C. E., & Peden-McAlpine, C. (2007). Decision making by families of older adults with advanced cognitive impairment: Spirituality and meaning. Journal of Gerontological Nursing, 33, 49–55.PubMed
go back to reference Fritsch, J., Petronio, S., Helft, P. R., & Torke, A. M. (2013). Making decisions for hospitalized older adults: ethical factors considered by family surrogates. Journal of Clinical Ethics, 24(2), 125–134.PubMed Fritsch, J., Petronio, S., Helft, P. R., & Torke, A. M. (2013). Making decisions for hospitalized older adults: ethical factors considered by family surrogates. Journal of Clinical Ethics, 24(2), 125–134.PubMed
go back to reference Giacomini, M. K., & Cook, D. J. (2000). Users’ guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA, 284(3), 357–362.CrossRefPubMed Giacomini, M. K., & Cook, D. J. (2000). Users’ guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA, 284(3), 357–362.CrossRefPubMed
go back to reference Hebert, R., Dubois, M. F., Wolfson, C., Chambers, L., & Cohen, C. (2001). Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(11), M693–M699.CrossRef Hebert, R., Dubois, M. F., Wolfson, C., Chambers, L., & Cohen, C. (2001). Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(11), M693–M699.CrossRef
go back to reference Karches, K. E., Chung, G. S., Arora, V., Meltzer, D. O., & Curlin, F. A. (2012). Religiosity, spirituality, and end-of-life planning: a single-site survey of medical inpatients. Journal of Pain and Symptom Management, 44, 843–851.CrossRefPubMedPubMedCentral Karches, K. E., Chung, G. S., Arora, V., Meltzer, D. O., & Curlin, F. A. (2012). Religiosity, spirituality, and end-of-life planning: a single-site survey of medical inpatients. Journal of Pain and Symptom Management, 44, 843–851.CrossRefPubMedPubMedCentral
go back to reference Lindlof, T. R., & Taylor, B. C. (2002). Qualitative communication research methods. Thousand Oaks, CA: Sage. Lindlof, T. R., & Taylor, B. C. (2002). Qualitative communication research methods. Thousand Oaks, CA: Sage.
go back to reference Mitchell, S. L., Kiely, D. K., Jones, R. N., Prigerson, H., Volicer, L., & Teno, J. M. (2006). Advanced dementia research in the nursing home: the CASCADE study. Alzheimer Disease and Associated Disorders, 20(3), 166–175.CrossRefPubMedPubMedCentral Mitchell, S. L., Kiely, D. K., Jones, R. N., Prigerson, H., Volicer, L., & Teno, J. M. (2006). Advanced dementia research in the nursing home: the CASCADE study. Alzheimer Disease and Associated Disorders, 20(3), 166–175.CrossRefPubMedPubMedCentral
go back to reference Raymont, V., Bingley, W., Buchanan, A., David, A. S., Hayward, P., Wessely, S., & Hotopf, M. (2004). Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet, 364(9443), 1421–1427.CrossRefPubMed Raymont, V., Bingley, W., Buchanan, A., David, A. S., Hayward, P., Wessely, S., & Hotopf, M. (2004). Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet, 364(9443), 1421–1427.CrossRefPubMed
go back to reference Rees, D. (2001). Death and bereavement: the psychological, religious and cultural interfaces. London: Whurr Publishers. Rees, D. (2001). Death and bereavement: the psychological, religious and cultural interfaces. London: Whurr Publishers.
go back to reference Silvestri, G. A., Knittig, S., Zoller, J. S., & Nietert, P. J. (2003). Importance of faith on medical decisions regarding cancer care. Journal of Clinical Oncology, 21(7), 1379–1382.CrossRefPubMed Silvestri, G. A., Knittig, S., Zoller, J. S., & Nietert, P. J. (2003). Importance of faith on medical decisions regarding cancer care. Journal of Clinical Oncology, 21(7), 1379–1382.CrossRefPubMed
go back to reference Strauss, A., & Corbin, J. (1998). Basics of qualitative research: techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage. Strauss, A., & Corbin, J. (1998). Basics of qualitative research: techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks, CA: Sage.
go back to reference Sullivan, M. A., Muskin, P. R., Feldman, S. J., & Haase, E. (2004). Effects of religiosity on patients’ perceptions of do-not-resuscitate status. Psychosomatics, 45(2), 119–128.CrossRefPubMed Sullivan, M. A., Muskin, P. R., Feldman, S. J., & Haase, E. (2004). Effects of religiosity on patients’ perceptions of do-not-resuscitate status. Psychosomatics, 45(2), 119–128.CrossRefPubMed
go back to reference Torke, A. M., Corbie-Smith, G. M., & Branch, W. T, Jr. (2004). African American patients’ perspectives on medical decision making. Archives of Internal Medicine, 164(5), 525–530.CrossRefPubMed Torke, A. M., Corbie-Smith, G. M., & Branch, W. T, Jr. (2004). African American patients’ perspectives on medical decision making. Archives of Internal Medicine, 164(5), 525–530.CrossRefPubMed
go back to reference Torke, A. M., Petronio, S., Purnell, C., Sachs, G. A., Helft, P. R., & Callahan, C. M. (2012). Communicating with clinicians: A study of surrogates for hospitalized older adults. Journal of the American Geriatrics Society, 60, 1401–1407.CrossRefPubMedPubMedCentral Torke, A. M., Petronio, S., Purnell, C., Sachs, G. A., Helft, P. R., & Callahan, C. M. (2012). Communicating with clinicians: A study of surrogates for hospitalized older adults. Journal of the American Geriatrics Society, 60, 1401–1407.CrossRefPubMedPubMedCentral
go back to reference Torke, A. M., Simmerling, M., Siegler, M., Kaya, D., & Alexander, G. C. (2008). Rethinking the ethical framework for surrogate decision making: a qualitative study of physicians. Journal of Clinical Ethics, 19(2), 110–119.PubMed Torke, A. M., Simmerling, M., Siegler, M., Kaya, D., & Alexander, G. C. (2008). Rethinking the ethical framework for surrogate decision making: a qualitative study of physicians. Journal of Clinical Ethics, 19(2), 110–119.PubMed
go back to reference Van Ness, P. H., & Larson, D. B. (2002). Religion, senescence, and mental health: the end of life is not the end of hope. The American Journal of Geriatric Psychiatry, 10(4), 386–397.CrossRefPubMedPubMedCentral Van Ness, P. H., & Larson, D. B. (2002). Religion, senescence, and mental health: the end of life is not the end of hope. The American Journal of Geriatric Psychiatry, 10(4), 386–397.CrossRefPubMedPubMedCentral
go back to reference Wall, R. J., Engelberg, R. A., Gries, C. J., Glavan, B., & Curtis, J. R. (2007). Spiritual care of families in the intensive care unit. Critical Care Medicine, 35(4), 1084–1090.CrossRefPubMed Wall, R. J., Engelberg, R. A., Gries, C. J., Glavan, B., & Curtis, J. R. (2007). Spiritual care of families in the intensive care unit. Critical Care Medicine, 35(4), 1084–1090.CrossRefPubMed
Metadata
Title
Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults
Authors
Kristin N. Geros-Willfond
Steven S. Ivy
Kianna Montz
Sara E. Bohan
Alexia M. Torke
Publication date
01-06-2016
Publisher
Springer US
Published in
Journal of Religion and Health / Issue 3/2016
Print ISSN: 0022-4197
Electronic ISSN: 1573-6571
DOI
https://doi.org/10.1007/s10943-015-0111-9

Other articles of this Issue 3/2016

Journal of Religion and Health 3/2016 Go to the issue