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Let's talk: The nature of the health care surrogate-clinician relationship
Date:8/8/2012

INDIANAPOLIS -- A new study from the Regenstrief Institute and Indiana University School of Medicine examines the relationship between family members who make decisions for hospitalized older adults with impaired cognition and the doctors, nurses and other clinicians who care for these patients.

The researchers report that in this era of fragmented care, families rarely get to know even the names of the many clinicians who care for their family members. Even a physician or nurse who was especially supportive or helpful to the family might see the family member only once or twice. Family members usually remembered that the person was a doctor, nurse or social worker but often apologized for being unable to remember the person's name.

"The patient's care is often passed from one doctor or nurse to the next as shifts change. The patient may be getting high-quality medical care, but it is often very fragmented," said Regenstrief Institute investigator Alexia Torke, M.D., M.S., assistant professor of medicine at the IU School of Medicine.

When hospitalized older adults have impaired cognition, family members or other surrogates must communicate with clinicians to make medical decisions as well as to provide information about the patient. In interviews conducted for the study, surrogate decision-makers were clear about the kind of support they needed: frequent communication, detailed information and expressions of emotional support from the health care providers. Surrogates said they appreciated this support even when it was often delivered by clinicians they hardly knew. Surrogates expressed their distress when they had to struggle for information or couldn't get frequent updates from the clinicians.

"Surrogate decision-makers are under a lot of stress from their loved one's illness, and they crave both information and support from those caring for their family member in the hospital," Dr. Torke said.

"Surrogates wa
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Contact: Cindy Fox Aisen
caisen@iupui.edu
317-843-2276
Indiana University School of Medicine
Source:Eurekalert  

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