Vol. 41 No. 1 January 2011 313Schedule with Abstracts

the issues that complicate care of patients withLVADs including infections, hemodynamic insta-bility, ethical issues surrounding discontinuation,and difficulties of transitions of care. Palliativeconsultation for this complex case helped to es-tablish his goals, including surgical removal, anddespite his death, allowed for those goals to becarried to fruition.

What Are We Asking? The Impact ofSurrogate Decision Making (766)Judith Webb, DNP, MGH Institute of Health Pro-fessions, Boston, MA.(Webb has disclosed no relevant financialrelationships.)

Objectives1. Discuss the clinical practice of end-of-life deci-

sion making.2. Describe the population of surrogate decision

makers.3. Compare the level of distress following death

of a loved one between decision-makers andnon-decision makers.

Background. Approximately 70% of adults morethan 60 years old will lose decision-making ca-pacity at the end of their lives, requiring a surro-gate to make decisions. Surrogate decisionmakers play an important role, yet little is knownthe long-term impact on them. Following thedeath of a loved one, people may experiencevarying degrees of psychological morbidity in-cluding PTSD.Research objectives. The purpose of the studywas to investigate the long-term impact of thedeath of a loved one and compare distress be-tween decision-makers and non-decisionmakers, and to determine prevalence of SDMsand further describe the population.Methods. This descriptive study used social net-works to conduct an electronic survey of adultswho have experienced the death of a lovedone in hospital and nonhospital settings. Dis-tress was measured using the Impact of EventScale-Revised.Results. Among 339 subjects, 37% had served assurrogate decision makers. Comparison of meanscores on the three subscales: intrusion, avoid-ance, and arousal, indicated both decisionmakers and non-decision makers reported mildto moderate distress within the previous week.Younger surrogates reported significantlygreater symptoms of intrusive thoughts andarousal, even though for a majority the death

had been longer than 3 years prior to the survey.Surrogates had less distress over time than didnonsurrogates.Conclusion. Healthcare providers regularly in-volve loved ones in making end-of-life decisions.Providers should consider not only the risks andbenefits to the patient, but the long-term effectsthese experiences may have on the survivors.Implications for research, policy, or practice. Anunderstanding of differences in long-term dis-tress among various groups of bereaved individ-uals will inform the clinical practice of healthcare providers when counseling loved ones dur-ing end-of-life decision making. When providersmust designate decision makers, the impact onyounger surrogates should be considered. Pro-viders may play a role in seeking group consen-sus as a buffer for this distress.

Risk Factors for Delirium in PatientsUndergoing Hematopoietic Stem CellTransplantation (767)Michelle Weckmann University of Iowa, IowaCity, IA.(Weckmann has disclosed no relevant financialrelationships.)

Objectives1. Identify the risk factors for delirium in hospi-

talized patients following hematopoietic stemcell transplantation (HSCT).

2. Recognize the morbidity and mortality re-lated to delirium in HSCT patients.

3. Discuss the benefits of screening high risk pa-tients for delirium.

Background. Increasingly, nonhospice palliativecare teams are asked to provide care for cancer pa-tients undergoing hematopoietic stem cell trans-plant (HSCT). Evidence suggests that earlyrecognition and treatment of delirium can im-prove long termoutcomes yet little is known aboutthe risk factors for delirium in this population.Research objectives. Determine the risk factorsfor delirium in hospitalized patients followingstem-cell transplantation.Methods. Fifty-four patients admitted to an aca-demic hospital for HSCT were assessed prospec-tively throughout their stay for delirium usingThe Memorial Delirium Assessment Scale(MDAS) and the Delirium Rating Scale (DRS).Patient’s self-reported medical history and com-puterized medical records were used to identifytransplantation risk factors.