Members of the American Geriatrics Society,

We request your participation in a brief online survey about your experiences working with socially isolated and vulnerable elderly patients.


Purpose:  The “AGS Position Statement: Making Medical Treatment Decisions for Unbefriended Older Adults”1 hich proposed policy and practice guidelines for patients who are “unbefriended” or at risk for becoming so.  We want to learn more about your experiences working with such patients and the strategies you have developed.

 

Information about the survey:

  • It’s completely voluntary.
  • Your answers will remain anonymous – no identifying information will be collected about your or your patients.  Your IP address will not be collected. 
  • It will take about 15 minutes to complete. 
  • The survey is being distributed to the AGS membership nationwide (approx. 5,000 members).
  • At the end of the survey, if you are interested, you may enter a drawing to win a free iPad.
  • The project has been reviewed and approved by the Research and Institutional Review Board Committees of VA Boston Healthcare System and the Ethics Committee and executive board of the American Geriatrics Society.
  • The project received funding from the Guardianship Policy Institute.

 

We are eager to gain your valuable perspective on these important issues.

 

Sincerely, 

 

Timothy Farrell, M.D., AGSF

University of Utah School of Medicine

VA Salt Lake City Geriatric Research, Education, and Clinical Center

 

Eric Widera, M.D.

University of California, San Francisco

San Francisco VAMC

 

Aanand Naik, M.D.

Baylor College of Medicine

Michael E. DeBakey VAMC

 

Jennifer Moye, Ph.D., ABPP

New England Geriatric Research Education and Clinical Center

Harvard Medical School

 

Casey Catlin, M.A.

Boston VA Research Institute, Inc.

Boston VAMC

 

1Farrell, T., Widera, E., Rosenberg, L., Rubin, C.D., Naik, A.D., Braun, U., Torke, A., Li, I., Vitale, C., Shega, J.; Ethics, Clinical Practice and Models of Care, and Public Policy Committees of the AGS.

AGS Position Statement: Making Medical Treatment Decisions for Unbefriended Older Adults. Journal of the Am Geriatr Soc. 2016 Nov 22; doi: 10.1111/jgs.14586. PMID:27874181.



We will use the following definitions from the AGS position statement.  Some find these problematic – we’ll ask you more about this later.


DEFINITIONS:


An "unbefriended older adult" is a person who: 

(a) lacks decisional capacity to provide informed consent;

(b) has not executed an advance directive;

(c) lacks a legal surrogate (e.g., is without a family / friends - isolated, estranged, bereaved - and there is not a professional acting in that role)

 

An "adult orphan" is an older adult at risk of becoming unbefriended who: 

     (a) currently retains decisional capacity;

     (b) has not executed an advance directive;

     (c) lacks a legal surrogate (e.g. is without a family / friends - isolated, estranged, bereaved - and there is not a professional acting in that role)


Therefore, both a person considered "unbefriended" and an "adult orphan" are isolated and lack advance directives.  The difference is that the term "unbefriended" is used to describe a person who currently lacks capacity, whereas an "adult orphan" retains capacity.



What is the clinical setting you work in most often?
25f97d938d8a44f3b05291586edffbcb Outpatient - home or clinic based 
25f97d938d8a44f3b05291586edffbcb Outpatient - other 
25f97d938d8a44f3b05291586edffbcb Inpatient - acute care 
25f97d938d8a44f3b05291586edffbcb Inpatient - rehab / subacute 
25f97d938d8a44f3b05291586edffbcb Inpatient - long term care 
25f97d938d8a44f3b05291586edffbcb Inpatient - other 
What is your panel size (outpatient) or average daily census (inpatient)?

If your primary work setting is INPATIENT, please answer the questions below, #3 - #12.

If your primary work setting is OUTPATIENT or LONG TERM CARE, please skip to question #13.  

If you work in both INPATIENT and OUTPATIENT or LONG TERM CARE, you may answer all questions if you wish.

 

Definition Reminder.  An "unbefriended older adult"

> No decisional capacity

> No advanced directive

> No legal surrogate (family or professional)


Before this survey, had you heard of the term "unbefriended"?

25f97d938d8a44f3b05291586edffbcb Yes 
25f97d938d8a44f3b05291586edffbcb No 
In the past year, how often have you cared for an "unbefriended" older adult?
25f97d938d8a44f3b05291586edffbcb Weekly (>1 time per week) 
25f97d938d8a44f3b05291586edffbcb Monthly (1-3 times per month) 
25f97d938d8a44f3b05291586edffbcb Quarterly (3-4 times per year) 
25f97d938d8a44f3b05291586edffbcb Annually (1 time per year) 
25f97d938d8a44f3b05291586edffbcb Never 
Have your unbefriended patients/ your team faced any of these problems?
NeverRarelySometimesFrequently
Prolonged hospital stay, past a medically necessary point
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Delay in treatment or surgery
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Delay in appropriately transitioning the patient to hospice or end of life care
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Unable to provide the patient something that may improve quality of life
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Delay in authorizing charges/coverage for care
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Loss of rehabilitation ability/potential in patient
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
We had to continue with what seemed like medically non-beneficial care
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
I experienced personal distress because of an inability to act in my professional role
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
The patient was in physical or psychological distress
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Other: describe below
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
If Other, please describe - also any additional comments?

Please briefly describe a recent example of a situation you encountered with an unbefriended older adult. What was challenging about working with this patient? How did you proceed?

For example:  “An adult with dementia and without known family or friends  lacked consent capacity.  Nursing home placement was recommended to facilitate rehabilitation from a hip fracture.  The nursing home would not accept the patient without a legal surrogate.  The patient remained in the inpatient setting for 68 days.  It was difficult to manage him on the inpatient setting due to his wandering and other dementia-related behaviors.”
What practices, strategies, or resources have you used to meet the needs of unbefriended older adults in your practice/ institution?

Many find the term “unbefriended” to be stigmatizing, undesirable, or not adequately descriptive. Alternatives are often wordy (e.g., “incapacitated, isolated, and unrepresented”).  Do you have suggestions for a different term to describe an older adult who lacks decisional capacity, lacks advance directives, and lacks a legal surrogate?

Below is a list of possible alternative terms for “unbefriended” (adult who lacks decisional capacity, lacks advance directives, and lacks family or friends able to serve as surrogate).

Please rank your top three choices (1-most desirable) for an alternative term.
Top ChoiceSecond ChoiceThird Choice
      1            2            3      
Unrepresented adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Incapacitated and alone
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Vulnerable isolated adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Unaccompanied adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Solitary adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Incapacitated adult without advocates
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Surrogate-less
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Proxy-less
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Proxy Vacans (Latin for "vacant proxy")
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Advocatus (Latin for "no advocate")
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Surrogatus (Latin for "no surrogate")
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Amicum (Latin for "no friend")
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Adultum Solum (Latin for "alone adult")
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
None of these - I prefer the term "unbefriended"
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
What is your highest professional degree?
25f97d938d8a44f3b05291586edffbcb MD/ DO 
25f97d938d8a44f3b05291586edffbcb PA  
25f97d938d8a44f3b05291586edffbcb NP 
25f97d938d8a44f3b05291586edffbcb RN 
25f97d938d8a44f3b05291586edffbcb PhD 
25f97d938d8a44f3b05291586edffbcb PharmD 
25f97d938d8a44f3b05291586edffbcb MSW 
25f97d938d8a44f3b05291586edffbcb Other 
What U.S. state do you practice in?
Optional: If you would be interested in participating in a future focus group or interview to discuss these topics in greater depth, please leave your name and contact information (email address or phone number) so we may follow up with you.

OUTPATIENT & LONG TERM CARE survey begins here



 

Definition Reminder.  An "unbefriended older adult"

> No decisional capacity

> No advanced directive

> No legal surrogate (family or professional)


Before this survey, had you heard of the term "unbefriended"?
25f97d938d8a44f3b05291586edffbcb Yes 
25f97d938d8a44f3b05291586edffbcb No 
In the past year, how often have you cared for an "unbefriended" older adult?
25f97d938d8a44f3b05291586edffbcb Weekly (>1 time per week) 
25f97d938d8a44f3b05291586edffbcb Monthly (1-3 times per month) 
25f97d938d8a44f3b05291586edffbcb Quarterly (3-4 times per year) 
25f97d938d8a44f3b05291586edffbcb Annually (1 time per year) 
25f97d938d8a44f3b05291586edffbcb Never 
Which clinical situations have brought a patient’s unbefriended status to your attention?
RarelySometimesFrequentlyN/A
Consent for medical procedure
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25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Concern re: medication self-management
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Concern re: safety
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Concern re: driving
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Elder Abuse/ Adult Protective issue
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Advance care planning process
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Other: please describe below
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
If other, please describe - also any additional comments?
Please briefly describe a recent example of a situation you encountered with an unbefriended older adult. What was challenging about working with this patient? How did you proceed? (Note: do not include any identifying information).
For example:  “An adult with dementia and without known family or friends lacked consent capacity.  Nursing home placement was recommended to facilitate rehabilitation from a hip fracture.  The nursing home would not accept the patient without a legal surrogate.  The patient remained in the inpatient setting for 68 days.  It was difficult to manage him on the inpatient setting due to his wandering and other dementia-related behaviors.”

What practices, strategies, or resources have you used to meet the needs of unbefriended older adults in your practice/ institution?
Many find the term “unbefriended” to be stigmatizing, undesirable, or not adequately descriptive. Alternatives are often wordy (e.g., “incapacitated, isolated, and unrepresented”). Do you have suggestions for a different term to describe an older adult who lacks decisional capacity, lacks advance directives, and lacks a legal surrogate? 
 
Below is a list of possible alternative terms for “unbefriended” to describe an older adult who lacks decisional capacity, lacks advance directives, and lacks family or friends able to serve as surrogate.

Please rank your top three choices (1-most desirable) for an alternative term.
Top ChoiceSecond ChoiceThird Choice
      1            2            3      
Unrepresented adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Incapacitated and alone
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Vulnerable isolated adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Unaccompanied adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Solitary adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Incapacitated adult without advocates
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Surrogate-less
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Proxy-less
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Proxy Vacans (Latin for “vacant proxy”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Advocatus (Latin for “no advocate”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Surrogatus (Latin for “no surrogate”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Amicum (Latin for “no friend”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Adultum Solum (Latin for “alone adult”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
None of these – I prefer the term “unbefriended”
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb

ADULT ORPHANS:


These final questions seek your input on ways to prevent “adult orphans” from becoming unbefriended. 

 
 

Definition Reminder.  An "adult orphan"

> Has decisional capacity

> No advanced directive

> No legal surrogate (family or professional)


Are there things you do to identify adult orphans in your practice / institution?
25f97d938d8a44f3b05291586edffbcb Yes 
25f97d938d8a44f3b05291586edffbcb No 
25f97d938d8a44f3b05291586edffbcb Unsure 
If you have instituted or could envision a process, please describe:
What would your practice need in order to better identify adult orphans and prevent them from becoming unbefriended? Check all that apply (if any).
00e4bef0a9d94a41bed49d1048864947 Time 
00e4bef0a9d94a41bed49d1048864947 Advance care planning supported by Medicare reimbursement 
00e4bef0a9d94a41bed49d1048864947 Care manager 
00e4bef0a9d94a41bed49d1048864947 Social worker 
00e4bef0a9d94a41bed49d1048864947 Pathway to partner with community or volunteer agency 
00e4bef0a9d94a41bed49d1048864947 Other 
Many find the term “adult orphan” to be stigmatizing, undesirable, or not adequately descriptive. Do you have suggestions for a different term to describe an older adult who retains decisional capacity, has not executed an advance directive, and lacks a legal surrogate?
Below is a list of possible alternative terms for “adult orphan” to describe an older adult who retains decisional capacity, has not executed an advance directive, and lacks a legal surrogate. Please rank your top three choices (1-most desirable) for an alternative term.
Top ChoiceSecond ChoiceThird Choice
      1            2            3      
Elder orphan
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Isolated vulnerable adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Lone elder
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Isolated adult at risk
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Adult without advocates
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Unprotected adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Companionless
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Solitary adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Solo adult
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Proxy Vacans (Latin for “vacant proxy”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Advocatus (Latin for “no advocate”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Surrogatus (Latin for “no surrogate”)
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
25f97d938d8a44f3b05291586edffbcb
Non Amicum (Latin for “no friend”)
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Adultum Solum (Latin for “alone adult”)
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None of these – I prefer the term “adult orphan”
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What is your highest professional degree?
25f97d938d8a44f3b05291586edffbcb MD / DO 
25f97d938d8a44f3b05291586edffbcb NP 
25f97d938d8a44f3b05291586edffbcb PA 
25f97d938d8a44f3b05291586edffbcb RN 
25f97d938d8a44f3b05291586edffbcb PhD 
25f97d938d8a44f3b05291586edffbcb PharmD 
25f97d938d8a44f3b05291586edffbcb MSW 
25f97d938d8a44f3b05291586edffbcb Other: specify: 
What U.S. state do you practice in?
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