PARTICIPATION OF CHRONICALLY ILL OLDER ADULTS IN THEIR LIFE-PROLONGING TREATMENT DECISIONS - RIGHTS AND OPPORTUNITY

The right of the individual to participate in herl life-prolonging tre atment decisions, either as a decision maker or by having her treatmen t wishes used as a decision-making criterion, is the result of an evol ution in legal guidelines over the last two decades. Although necessar y, these legal guidelines are however not sufficient to assure the ind ividual's opportunity to participate. For the chronically ill older ad ult residing in a health care institution, the opportunity to particip ate in decisions concerning life-prolonging treatments implicitly depe nds on the effective communication among three key actors (the individ ual, her physician, and her proxy). The necessity of this communicatio n has important implications for clinical practice and future empirica l research.