The goal of this dissertation research is to describe what it is like for a surrogate decision maker [SDM] to live through the implementation of an Advance Proxy Plan [APP] treatment decision made by the SDM for their loved one with advanced dementia of the Alzheimer's type [DAT]. The APP treatment decision is a hypothetical plan until the patient with DAT experiences an event, or physiological crisis that calls upon a component of the plan to be instituted. Therefore, this research will go beyond the APP treatment decision to learn what it is actually like for the SDM to live through the specific components of the APP treatment decision as these components are carried out by health care providers. An APP treatment decision may speck aggressive or palliative care. This research will be conducted at the Edith Nourse Rogers Memorial Veterans Hospital, a Department of Veterans Affairs hospital in Bedford, MA. Therefore the SDMs selected for this research will be wives of male patients with advanced DAT. The phenomenologicaI method described by VanManen (1990) will be employed by the researcher to learn about the experience of the SDM in living through the APP treatment decision for a loved one with advanced DAT. This research will contribute significantly to clinical nursing ethics as little is known about the experiences of SDMs in carrying out APP treatment decisions for incompetent patients. Research findings will provide nurses, with increased understanding to assess the concerns of SDMs as they make and carry out APP treatment decisions for their loved ones with DAT.
