Surrogate Decision-making Regarding Terminal Care for the Elderly by Family Members

A Literature Review

Abstract

  This literature review aimed to clarify the research trends and future research issues related to the surrogate decision-making by family members in Japan by focusing on terminal care for the elderly. Thirty-nine papers matched our study objectives and were analyzed. The oldest publication was from 2000, and it has been reported annually since 2006. The most adopted methodology, research design, analysis method, and location were “qualitative research,” “descriptive research,” “qualitative inductive analysis,” “descriptive statistics,” and “hospital,” respectively. “Family and bereaved families” accounted for about half of the research participants.

  The results were summarized into the following six categories: “family’s feelings toward surrogate decision-making,” “family’s decision-making processes,” “support from experts during family’s decision-making,” “nurses’ perceptions about surrogate decisions by family members,” “elderly adults’ thoughts about surrogate decision-making,” and “differences in terminal care intentions based on position.” Future interventional studies should address how to reduce the mental distress that families experience during the surrogate decision-making process.