Journal article
“They Make the Will, But They Want the Food:” Staff Perspectives on Challenges in Implementing Dementia Advance Directives Related to Stopping Feeding
Journal of social work in end-of-life & palliative care, Vol.20(3), pp.254-275
07/2024
DOI: 10.1080/15524256.2024.2365368
PMID: 38949629
Abstract
Dementia-specific advance directives are publicly available. This study breaks new ground by asking nursing home (NH) staff their perspectives of dementia-specific advance directives that offer the option of no assistance with feeding, once the ability to self-feed is lost. This pilot study uses qualitative descriptive methodology to plan, collect and analyze in-person interviews with 12 NH staff (nurses, social workers, nursing assistants, dietitians, physician) from one large facility in northeast USA. Results underscore logistic challenges (language ambiguity, the fluctuating nature of dementia, honoring “then-self” or “now-self” determination), and moral challenges related to harm. Key concepts in the directives need to be defined. Policies to operationalize the directives are needed. Attempting to implement these directives in NHs, in their current form, would likely be problematic.
Details
- Title: Subtitle
- “They Make the Will, But They Want the Food:” Staff Perspectives on Challenges in Implementing Dementia Advance Directives Related to Stopping Feeding
- Creators
- Meredith Levine - Hebrew HomeMercedes Bern-Klug - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of social work in end-of-life & palliative care, Vol.20(3), pp.254-275
- DOI
- 10.1080/15524256.2024.2365368
- PMID
- 38949629
- NLM abbreviation
- J Soc Work End Life Palliat Care
- ISSN
- 1552-4256
- eISSN
- 1552-4264
- Language
- English
- Date published
- 07/2024
- Academic Unit
- International Programs; School of Social Work
- Record Identifier
- 9984656628902771
Metrics
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