Darin Zahuranec, MD—Understanding Stroke: a decision support tool for surrogates facing decisions on life-sustaining treatments.
Abstract: Stroke remains a leading cause of death and disability in the United States. Most cases of early post-stroke death occur after a decision is made to limit life-sustaining treatments such as feeding tubes or mechanical ventilation. These decision are typically made by a family surrogate decision maker due to impairments in the patient’s capacity to make their own decisions. Prior work has shown that many surrogates are ill-prepared to make these decisions, as they are often in considerable emotional distress, may have difficulty separating their own values from what the patient would have wanted, and may be prone to undue influence from physicians. We developed “Understanding Stroke,” a web-based decision support tool to help surrogates facing these difficult decisions. We will describe the development process and results from our pilot study of this tool and hope to discuss next steps in improving the process of surrogate decision making during acute hospitalizations.
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