INFLUENCE OF A VALUES DISCUSSION ON CONGRUENCE BETWEEN ELDERLY WOMEN AND THEIR FAMILIES ON CRITICAL HEALTH-CARE DECISIONS

This study investigated if prior discussion of values by competent old er women (N = 60) with their proxies assisted these proxies to make cr itical health care decisions in congruence with the desires of the wom en. Women were randomly assigned to experimental or control groups. Ex perimental treatment consisted of discussion of value indicators in th e presence of their proxies. The proxies were instructed to make decis ions in 10 situations across 3 mental states using the substituted jud gment standard. The experimental group did not have statistically high er agreement than women-proxy pairs in the control group in 27 of the 30 situations, but they had greater percentage agreement in 11 of the situations. Limitations of the Kappa statistic in health care agreemen t studies were addressed. The mean treatment decision scores were sign ificantly different across mental states, indicating as mental acuity was decreased in the scenarios, the women were more likely to refuse t he recommended treatment.