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ERIC Number: EJ824391
Record Type: Journal
Publication Date: 2008-Dec
Pages: 9
Abstractor: As Provided
Reference Count: 0
ISSN: ISSN-0016-9013
Spouses' Effectiveness as End-of-Life Health Care Surrogates: Accuracy, Uncertainty, and Errors of Overtreatment or Undertreatment
Moorman, Sara M.; Carr, Deborah
Gerontologist, v48 n6 p811-819 Dec 2008
Purpose: We document the extent to which older adults accurately report their spouses' end-of-life treatment preferences, in the hypothetical scenarios of terminal illness with severe physical pain and terminal illness with severe cognitive impairment. We investigate the extent to which accurate reports, inaccurate reports (i.e., errors of undertreatment or overtreatment), and uncertain reports (responses of "do not know") are associated with spouses' advance care planning and surrogates' involvement in the planning. Design and Methods: We used data from married couples who participated in the Wisconsin Longitudinal Study in 2004. These 2,750 couples were in their mid-60s and in relatively good health. We conducted multinomial logistic regressions. Results: Surrogates were accurate in the majority of cases, made errors in 12% to 22% of cases, and were uncertain in 11% to 16% of cases. Errors of overtreatment and undertreatment were equally prevalent. For both scenarios, discussing preferences was associated with lower odds of an uncertain surrogate response. Implications: We suggest ways that health care practitioners could facilitate family-level conversations in order to ensure that patients' preferences are accurately represented in end-of-life care settings.
Gerontological Society of America. 1030 15th Street NW Suite 250, Washington, DC 20005. Tel: 202-842-1275; Fax: 202-842-1150; e-mail:; Web site:
Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Audience: Practitioners
Language: English
Sponsor: N/A
Authoring Institution: N/A