ABSTRACT

Persons without family or friends to serve as healthcare agents may become “unrepresented” in healthcare, with no one to serve as healthcare agents when decisional support is needed. Surveys of clinicians (N = 81) and attorneys/guardians (N = 23) in Massachusetts reveal that unrepresented adults experience prolonged hospital stays (66%), delays in receiving palliative care (52%), delays in treatment (49%), and other negative consequences. Clinicians say guardianship is most helpful in resolving issues related to care transitions, medical treatment, quality of life, housing, finances, and safety. However, experiences with guardianship are varied, with delays often/always in court appointments (43%) and actions after appointments (24%). Policy solutions include legal reform, education, and alternate models.

摘要

没有家人或朋友担任医疗保健代理人的人可能会在医疗保健中变得“无人代表”，在需要决策支持时没有人担任医疗保健代理人。对马萨诸塞州临床医生 (N = 81) 和律师/监护人 (N = 23) 的调查显示，无人代表的成年人住院时间延长 (66%)、接受姑息治疗 (52%) 延误、治疗延误 (49%)、和其他负面后果。临床医生表示，监护最有助于解决与护理过渡、医疗、生活质量、住房、财务和安全相关的问题。然而，监护人的经历各不相同，经常/总是延误法庭任命 (43%) 和任命后的行动 (24%)。政策解决方案包括法律改革、教育和替代模式。