Impact of End-of-Life Planning on Surrogate Decision-Maker Anxiety

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April Aloiau

Sea Crest Hospice, USA

: J Nurs Patient Care

Abstract

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At the end of life, adults with advanced illness frequently rely on surrogate decision makers to make health care decisions. Surrogate decision makers have anxiety related to the difficulty and complexity of making end of life decisions. This project evaluated whether an educational intervention to create a specific plan of care for hospice patients would reduce anxiety among their surrogate decision makers. The Geriatric Anxiety Scale, the State Trait Anxiety Inventory, State Anxiety Scale, and a single question about decisionmaking anxiety were used to measure surrogate decision maker anxiety before the intervention, immediately after the intervention, and 2 weeks following the intervention. Twelve patients (age 80 ± 14.7 years) and 18 surrogate decision makers (age 60 ± 12.9 years) from a Southern California hospice organization completed the intervention. Immediately following the intervention surrogate decision makers showed a significant decrease (p = 0.003) in anxiety. When surrogate decision maker anxiety was measured 2 weeks post-intervention, anxiety had increased again, so that it was no longer significantly different from preintervention levels. This project demonstrated that an educational intervention in the hospice setting can be effective in creating a short-term decrease to surrogate decision maker anxiety levels.

Biography

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April Aloiau is a doctor of nursing practice specializing in geriatric medicine. She have worked in hospice and home health for the past eight years. The corner stones of her practice are compassion and patient education. The patient education, she provide is regarding the choices available to the patient as well as the benefits vs the risks of each choice. She take the time to understand what is important to the patient and their family and address their questions and concerns. As a DNP, she have presented her research at the national Gerontological Scientific conference. This year’s topic “Impact of End-of-Life Planning on Reducing Surrogate Decision-Maker Anxiety” was published in the International Journal of Palliative Nursing on March 3, 2020. She earned her Bachelors of Science Nursing at Concordia University in Irvine and her doctorate of nursing practice (DNP) at the University of Colorado. She was selected as a 2019 outstanding nurse finalist by Orange County’s SeniorServ.