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Table 1 Involvement of patient and family members in decisions regarding treatment

From: How do nursing home doctors involve patients and next of kin in end-of-life decisions? A qualitative study from Norway

Time of discussion
  • In conjunction with routine checks, and other similar situationsa
  • When the patient becomes noticeably more frail (anticipating the issue of life-extending treatment in the near future)a
  • In conjunction with hospital admission
  • When the patient becomes acutely ill
Form and content of discussions
  • Primarily information about regular routines, or if decisions have already been made
   a) Discussion in advance: “this is how things are usually done here”
   b) Discussion in an acute situation: inform of the decisions that have been made
  • Focus on dialogue
  • Allow family members to influence whether or not the patient should have treatment
Doctors’ reasons for discussions
  • Considered routine practice
  • Family members have requested it
  • The doctor assesses the need for discussion or information
  • The nurses assess the need for discussion or information
 
  1. aOften defined as “advance care planning”