DEMENTIA CAREGIVER PREPAREDNESS FOR SURROGATE DECISION-MAKING: SPECIFICITY AND CONFIDENCE IN CARE PLANNING - Abstract citation ID igaf122.4285

Q: Why are advance care planning (ACP) conversations important for dementia surrogates?

ACP conversations can reduce decision-making burden for surrogates, but they often occur only in later dementia stages, leaving earlier preparedness gaps.

Q: How did the study measure caregivers’ preparedness?

It used semi-structured interviews with a novel content coding system to assess caregivers’ confidence and specificity in care planning, alongside survey measures of self-efficacy, mutuality, burden, preparedness, and ACP engagement.

Q: What was the relationship between confidence and ACP engagement?

Confidence was positively correlated with ACP engagement (r = .42, p = .01), while lack of confidence showed a negative correlation (r = -.46, p < .01).

Q: What did the study find about specificity in planning?

Specificity was negatively correlated with self-efficacy in obtaining respite (r = -.38, p = .03), negatively correlated with burden (r = -.45, p < .01), and positively correlated with mutuality (r = .35, p < .05).

Sep 29, 2026

Uploaded by Danger Angel

Dementia family caregivers often serve as medical surrogate decision-makers near the end of life, yet advance care planning (ACP) conversations are frequently delayed until later stages. This study evaluates surrogate decision-making preparedness in 34 dementia caregivers using semi-structured interviews and a novel coding system measuring confidence and specificity in planning and preference understanding. Survey measures covered self-efficacy, preparedness, mutuality, burden, and ACP engagement. Confidence correlated positively with ACP engagement, while lack of confidence correlated negatively. Specificity showed distinct associations with self-efficacy, burden, and mutuality.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Study aim and context

Methods and measures

Key findings and implications

Innovation in Aging, 2025, Vol. 9, No. S2 1285 Abstract citation ID: igaf122.4285 DEMENTIA CAREGIVER PREPAREDNESS FOR SURROGATE DECISION-MAKING: SPECIFICITY AND CONFIDENCE IN CARE PLANNING Rachel Bloom1, Elizabeth Rojas2, Emily LeRolland3, and Francesca Falzarano2, 1. Yale University, New York, New York, United States, 2. University of Southern California, Los Angeles, California, United States, 3. Fordham University, Bronx, New York, United States Dementia family caregivers commonly find themselves serving as medical surrogate decision-makers as the person with dementia nears their end of life. Engagement in advance care planning (ACP) conversations has been found to alleviate decision-making burden among surrogates, but these conversations rarely take place before the later stages of dementia. This study examines dementia caregivers’ (N = 34) surrogate decision-making preparedness, using a semi-structured interview to ask about care planning conversations with their family member and their role as potential surrogates. We developed and applied a novel content coding system to assess caregivers’ confidence and specificity in their planning approach and understanding of preferences. Survey data on self-efficacy, preparedness, mutuality, burden, andACP engagement were also collected. We found that the presence of confidence was positively correlated with ACP engagement (r = .42, p = .01), while lack of confidence was negatively correlated with ACP engagement (r = -.46, p < .01) . The presence of specificity was negatively correlated with self-efficacy in obtaining respite (r = -.38, p = .03), and lack of specificity was negatively correlated with burden (r = -.45, p < .01) and positively correlated with mutuality (r = .35, p < .05) . The association between a lack of specificity and mutuality may reflect an assumption that specific planning is unnecessary when relationship quality is high. This work helps to elucidate the relationships between different aspects of surrogate decision-making for people with dementia and provides touchpoints for future decision-making preparedness research and interventions involving family caregivers.

FAQs

Why are advance care planning (ACP) conversations important for dementia surrogates?

ACP conversations can reduce decision-making burden for surrogates, but they often occur only in later dementia stages, leaving earlier preparedness gaps.

How did the study measure caregivers’ preparedness?

It used semi-structured interviews with a novel content coding system to assess caregivers’ confidence and specificity in care planning, alongside survey measures of self-efficacy, mutuality, burden, preparedness, and ACP engagement.

What was the relationship between confidence and ACP engagement?

Confidence was positively correlated with ACP engagement (r = .42, p = .01), while lack of confidence showed a negative correlation (r = -.46, p < .01).

What did the study find about specificity in planning?

Specificity was negatively correlated with self-efficacy in obtaining respite (r = -.38, p = .03), negatively correlated with burden (r = -.45, p < .01), and positively correlated with mutuality (r = .35, p < .05).

Sep 29, 2026

Uploaded by Danger Angel