Health Care Decision Making

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Geriatric Care Managers … coordinating services to optimize health and quality of life.

The National Association of Professional Geriatric Care Managers (NAPGCM) is an organization of practitioners whose goal is the advancement of expert assistance to older adults and their families. NAPGCM is committed to maximizing the independence and autonomy of elders and strives to ensure the highest quality and most cost-effective health and human services. Members help older persons and their families cope with the challenges of aging, through education, advocacy, counseling, and service delivery.

Health Care Decision Making

The NAPGCM “Code of Ethics” states NAPGCM members respect clients’ rights to self-determination. To honor that obligation, it is essential health care professionals respect client/patients as the source of control as well as client/patient values and preferences.  Decisions made by competent individuals, or the authorized agents of individuals who lack capacity, should be honored by health care professionals.

I. NAPGCM supports:

  1. The utilization of informed decision-making where information is shared between individuals and/or their authorized agents and medical professionals in deciding course of treatment, particularly for tests or treatments where there is not just one clearly superior option.
  2. The use of decision-aides to help individuals and/or their authorized agents decide course of treatment. Such decision-aides should:
  1. Incorporate a variety of methods to share information respectful of an individual’s abilities, disabilities, language, or culture including written materials, videos, physical models, or interactive presentations.
  2. Be brief, written at the 8th grade level, and accessible to those who are hearing or visually impaired.
  3. Inform the individual about evidence-based care options and their outcomes along with the relative costs while explaining benefits and possible side effects as well the health care team’s skills for the respective treatment options.
  4. Help facilitate the airing of the individual’s or authorized agents concerns, fears and goals with the appropriate health care professionals.
  1. A system where decisions about end-of-life care such as sustaining, withdrawing or withholding medical treatment, as well consideration of palliative measures/comfort care, are made on an individualized basis, respectful of advance directives and patient values/preferences, and incorporate the input of all members of the care-giving team including authorized agents, family members, medical providers, and mental health professionals, as well as the individual, as able.
  2. The education of the public regarding health care decision-making issues, and the creation of partnerships with allied organizations in order to accomplish this goal.

II. NAPGCM advocates: the document designed to appoint an agent to make health care decisions in the event of incapacity of the individual be readily available, easily understandable and simple to complete with instructions attached.

III. NAPGCM encourages: the development and use of ethics committees by all health care organizations including hospitals, nursing homes, RCFEs, assisted living facilities and home and community based services. NAPGCM encourages partnering to develop model materials that would be made available to these organizations’ ethics committees.

Resolution Approved by the NAPGCM Board of Directors October 21, 1999.
Position Paper was reviewed, updated and approved by the Public Policy Committee on December 17, 2007.
Position Paper was reviewed, updated and approved by the Board of Directors on February 2, 2008.
Position Paper was reviewed and updated by the Public Policy Committee, and approved by the Board of Directors on April 30, 2014.