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Emergency medical services providers' perspective of end‐of‐life decision making for people with intellectual disabilities
Author(s) -
McGinley Jacqueline,
Waldrop Deborah P,
Clemency Brian
Publication year - 2017
Publication title -
journal of applied research in intellectual disabilities
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 63
eISSN - 1468-3148
pISSN - 1360-2322
DOI - 10.1111/jar.12363
Subject(s) - intellectual disability , context (archaeology) , perspective (graphical) , exploratory research , psychology , qualitative research , end of life care , nursing , medicine , psychiatry , sociology , palliative care , paleontology , social science , artificial intelligence , computer science , anthropology , biology
Background Emergency medical services ( EMS ) providers are often called to rapidly determine and act upon patients' wishes for end‐of‐life care. People with intellectual disabilities are living increasingly longer with complex conditions leading to international calls for person‐centred advance care planning. Yet, best estimates suggest that very few people with intellectual disabilities document their wishes. Methods This exploratory‐descriptive study incorporated mixed methods to analyse data collected consecutively (surveys, n = 239; interviews, n = 48) with EMS providers from five agencies. Data were subjected to a sequential quantitative–qualitative analysis applying a critical discourse analysis framework. Results Findings indicate that 62.7% had treated a person with intellectual disability who had medical orders directing end‐of‐life care. Three themes (provider familiarity, organizational processes, sociocultural context) offer insights about how medical orders inform EMS providers during calls involving people with intellectual disabilities. Conclusion Multiple contexts influence how wishes are documented and care provided to people with intellectual disabilities near life's end.