REACHING CONSENSUS - THE PROCESS OF RECOMMENDING TREATMENT DECISIONS FOR ALZHEIMERS PATIENTS

Observational and interview data obtained from nurse caregivers and fa mily members of patients with late-stage Alzheimer's disease were anal yzed to explicate the nursing role in advance proxy planning. A four-p hase model, Achieving Consensus: Decision Making to Determine Treatmen t Options for Patients with Alzheimer's Disease, was developed. Patien t decline, family coping, professional development of nursing staff, a nd nursing unit philosophy were community characteristics found to be important antecedents to the process of reaching consensus. Achieving consensus constructs included interactive process components of patien t, family, and staff adjustment, caring, and knowing. Timing and trust were influential catalysts to family and staff readiness factors for achieving consensus. Outcomes were the advice provided by staff and th e family conference where treatment options were determined. Consequen ces included the advance proxy plan and patient care.