Power Of Attorney Research Articles

Knowledge and perception of older adults toward end of life and advanced directive in Nigeria.

Older adults often have a heightened awareness of death due to personal losses. In many low- and middle-income countries, including Nigeria, conversation about end-of-life issues and advanced care planning (ACP) among older adults is gradually emerging. Our study explored older adults' knowledge and perceptions towards advanced directives and end-of-life issues in a geriatric care setting in Nigeria. A cross-sectional study was conducted among older adults (aged ≥60 years) in a geriatric outpatient clinic. Data were collected using an interviewer-administered, semi-structured questionnaire, tested at a significance level set at alpha 0.05. The study included 204 participants with a mean age of 71.3 ± 7.2 years, predominantly female (67.2%). Few of the participants have heard about end of life (20.1%), living will (19.1%), power of attorney (19.6%), and ACP (25.9%). About 29.9% of the respondents considered having a living will, of which about 34.4% have written one. Only 23 (11.3%) would consider discussing ACP in the future, 32 (15.7%) would discuss place of care, and 30 (14.7%) place of death. Preparedness for end of life and knowledge of ACP was higher among males, those with formal education, and those with good self-rated health (p < 0.05). The study highlighted gap in awareness and engagement in ACP among older adults in a country like Nigeria. This lack of knowledge can lead to inadequate end-of-life care and unpreparedness for critical health decisions for older adults in Africa. Thus, improving awareness and understanding of ACP can empower older adults, ensuring their end-of-life preferences are respected, enhancing the quality of care, and reducing the emotional and financial burden on families.

Health and care lasting power of attorney: key features.

In the first of a series of articles on decision-makers under the Mental Capacity Act 2005,Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers lasting power of attorney and its impact.

Abstract C005: Predictors of advance care planning documentation in female patients with breast cancer: A multilevel model analysis

Abstract Background: Advance care planning (ACP) is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. Likewise, ACP is associated with multiple benefits, such as lower rates of hospitalizations and reduced futile, aggressive cancer treatment at the end of life. However, ACP rates remain low in the U.S., especially for patients with advanced cancer. Despite being more likely to be diagnosed at advanced stages and hospitalized due to advanced cancer with poor prognosis, the Black and Hispanic/Latino populations continue to have meager rates of ACP. Research has shown that both individual-level and systems-level factors contribute to these racial disparities in ACP. Considering these disparities among vulnerable populations, interventions that increase ACP among minority patients with cancer are needed. Objective: To analyze using multilevel model analysis the predictors of ACP documentation in female patients with breast cancer over 5 years in the UChicago Health System. Methods: Using the Clinical Data Research Warehouse, this study included women diagnosed with breast cancer (N=7,814) from 2016 to 2021. Descriptive statistics were performed to characterize ACP, and potential differences in ACP rates among control variables were assessed using odds ratio (OR) estimations. Significantly correlated variables were included as covariates in the multivariate analyses through a logistic regression model. The multilevel random-effects (mixed-effects) model, using restricted maximum likelihood estimation, examined the pattern of ACP documentation; in the multilevel model, level 1 modeled the changes in individual ACP documentation, and level 2 included the between-subjects effects of the predictors of documentation. Results: 13.76% of women with breast cancer filled out at least one type of ACP documentation, 4.25% filled out the Power of Attorney, 5.75% filled out the Advance Directive, and 8.92% filled out the Code Status. Increasing age and being black/African-American seem to be related to an increased likelihood of completion of at least one type of ACP documentation. While increasing BMI and outpatient services seem to be related to a decrease in the likelihood of completing at least one type of ACP documentation. Conclusion: Understanding the factors related to ACP documentation will allow us to manage them and improve their completion. These results will help to inform the development of tools to increase the integration of ACP into care, especially those that are technology-based. Further work could include designing a predictive model to prioritize patients requiring ACP. Providing knowledge about ACP in nonclinical areas can lead to increased education about ACP and its benefits to families and communities. Citation Format: Andres Mauricio Garcia Sierra, Marcia Tan. Predictors of advance care planning documentation in female patients with breast cancer: A multilevel model analysis [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C005.

The Law, Dementia, and Sexuality-Is the Law Striking the Right Balance?

English and Welsh laws require "contemporaneous" consent to sexual relations, often precluding "non-capacituos" people living with advanced dementia from these human interactions. The views of people living with dementia, carers, professionals, and over-55s were explored on implications of current laws on sexuality in dementia. Thirty-five participants from England were recruited through purposive selective sampling. Audio-taped semistructured interviews were transcribed and thematically analyzed with each stakeholder group coded separately. Common themes across stakeholders were (i) law reform needed due to their hammer-like effect ignoring the individual; (ii) dissonant theme of needing the law for protection; (iii) negative impact of denied intimacy on individuals and partners; (iv) support for Advance Decisions on Intimacy with caveats; (v) less support for involvement of Court of Protection and Powers of Attorney; (vi) call for review of capacity concept with support for an assent model. People living with dementia described shame and stigma associated with policing of their sexuality and perception of being singled out for protection and intrusion into their lives. For informal carers (mostly wives), the theme of "what about me" emerged, demonstrating that for the long-term partnered, this is a couple's issue. Practical implications of this study include need to address ageism and ableism; human rights education for society and professionals; starting point of presumed capacity for sexual relations with consensus on how and when this should be rebutted; and care homes' certification requirements should incorporate assessment of the relationship health of their residents.

THE LEGAL POSITION OF THE HUMAN RESOURCES POSITION IN REPRESENTING THE LEGAL INTERESTS OF EMPLOYERS IN THE WORK AGREEMENT BETWEEN EMPLOYERS AND EMPLOYEES

Human resources positions in companies hold a strategic role in empowering and optimizing employee performance, which contributes to the company’s progress. As an employee of the company, the human resources position holds a legal position in managing employee matters and board of directors policies that represent the company’s interests. In order to carry out this role, the human resources position requires authorization in order to ensure a strong legal foundation, thus ensuring that the actions taken are not detrimental to the company. This research applies normative juridical method with secondary data collected through literature study and analyzed qualitatively normative. HR’s position is important in representing the employer’s legal interests, but is limited by company regulations. Delegation of legal authority must be regulated by law and cannot be arbitrary. Rights and obligations in the employment agreement remain with the employer unless there is an official power of attorney. Without a power of attorney, HR actions are invalid. Proper delegation provides a strong legal basis for HR, especially in employment agreements. Employment Law emphasizes the importance of official delegation for HR actions to be valid, so without a power of attorney, legal responsibility becomes personal, not corporate.

Powers Of Attorney - Shouldn't every dentist have one?

Powers Of Attorney - Shouldn't every dentist have one?

Considerations for Alternative Decision-Making When Transitioning to Adulthood for Youth With Intellectual and Developmental Disabilities: Policy Statement.

With advances in medical care, more youth with intellectual and/or developmental disabilities (IDD) are transitioning into adulthood. Patient- and family-centered, integrated care is warranted around this time of transition. Support teams (including the youth, caregivers, teachers, and pediatricians) should engage in transition planning, ideally starting between 12 and 14 years of age, to identify and develop resources to support the maturing youth's capacity for independent decision-making. Care teams should consider the varied levels of alternative decision-making support, which may include supported decision-making, medical proxy decision-making, power of attorney, and/or establishment of legal guardianship arrangements, to support the youth's health and well-being optimally. Ultimately, if independent decision-making is not appropriate, the goal for youth with IDD should be the least restrictive alternative, while preserving human rights and human dignity and promoting their autonomy. These considerations review alternative decision-making support, concepts, and legal requirements available for youth with IDD and their care teams. Pediatricians can support youth with IDD and their families in the transition process and decision-making autonomy by actively engaging the youth in care decisions, supporting needs for augmentative communication, fostering their expression of preferences and understanding of care decisions, and linking them to resources such as the medical-legal partnership model.

Digitale Informationsmaterialen über Demenz – Eine explorative inhaltsanalytische Betrachtung

ZusammenfassungHintergrundEine Demenzdiagnose bedeutet eine hohe Belastung für die Betroffenen und ihre Angehörigen. Häufig müssen schwierige Entscheidungen getroffen werden. Idealerweise treffen Menschen mit einer neuen Demenzdiagnose informierte Entscheidungen gemeinsam mit Angehörigen. Im Vorfeld einer informierten Entscheidung sind digitale Informationsmaterialien eine wichtige niederschwellige Quelle. Sie sollten möglichst umfassend über Demenz aufklären, sowohl zur Primärprävention (Risikofaktoren für Demenzentstehung) als auch zu späteren Behandlungsmöglichkeiten. Auch über vorsorgliche Maßnahmen, die spätere Entscheidungen erleichtern können (bspw. Patient*innenverfügung, Vorsorgevollmacht), sollte informiert werden. Einen umfassenden Überblick über die diversen Onlineangebote zu Demenzerkrankungen gibt es bisher nicht.MethodeDaher untersucht diese Studie im deutschen Sprachraum mittels einer innovativen systematischen Suchstrategie, welche demenzbezogenen Informationsangebote es digital für welche Zielgruppen gibt und wie diese Materialien inhaltlich hinsichtlich Risikofaktoren und Behandlungsmaßnahmen sowie Entscheidungsunterstützungen aufbereitet sind. Dieser methodische Ansatz ist neu und wird daher ausführlich vorgestellt und diskutiert.ErgebnisseDie Ergebnisse zeigen, dass die meisten Materialien für Menschen mit Demenz sowie deren Angehörige aufbereitet sind. Häufig werden Behandlungsmaßnahmen thematisiert, ohne die Risikofaktoren zu erklären, auf die diese Maßnahmen abzielen. Auf präventive Maßnahmen zur Entscheidungsunterstützung wird kaum eingegangen.DiskussionDie unausgewogene Darstellung kann dazu führen, dass einzelne Maßnahmen (für Laien) schwer nachvollziehbar sind oder Risikofaktoren falsch eingeordnet werden. Wichtige Implikationen werden abgeleitet.

Frequency and barriers to the patient advanced directive and lasting power of attorney: findings from a prospective observation study in palliative care services

The advance directive and lasting power of attorney are instruments to strengthen patients' autonomy. Ahospital-based palliative care consultation service can advise patients and family members about these instruments. This study investigates the need for such consultation among patients with life-limiting illness. This prospective observational study on intensive and non-intensive care units includes patients with arequest for palliative care consultation. Patient-related factors were evaluated for their possible association with the presence or absence of advance directives or power of attorney. In addition, focus group interviews with members of the palliative care consultation team were carried out to identify barriers which prevent patients from drawing up such documents. Atotal of 241 oncological and 53non-oncological patients were included with amedian age of 67years; 69(23%) patients were treated in the intensive care unit (ICU). Overall, 98(33%) patients had advance directives, and 133 (45%) had determined alegal health care proxy in advance. Atotal of 52patients died in hospital (17.7%). Only age and relationship status were associated with directives. In interviews, the following barriers were identified: information deficit, concern regarding discontinuation of treatment, loss of autonomy and wish to avoid aburden for the family. The majority in this severely ill patient population lack advance directives. In order to remove barriers, more effective information and counseling is required about such directives. In particular, guidance should include potential clinical situations in which such directives are potentially beneficial.

Juridical Review of Replacement Certificates of Land Rights Due to Loss at the Medan City Land Office

An application for a replacement certificate can only be made by the party whose name appears as the right holder in the land book at the local land office. An application for a replacement certificate cannot be made if the name of the party is different from the name of the right holder in the land book. If the right holder listed in the land book has died, the application can be made by his heirs. The application must be accompanied by valid supporting documents, such as a Certificate of Death from the right holder and a Certificate of Heirs and Heirs. The formulation of the problem in this research is How is the Procedure for the Implementation of the Issuance of Land Rights Substitute Certificates at the Medan City Land Office. How are the obstacles and efforts faced by the Medan City Land Office in the Implementation of the Issuance of Replacement Certificates of Land Rights that are lost. The type of research used in this research is juridical-empirical. Juridical-empirical research is legal research on the enactment or implementation of normative legal provisions directly on each specific legal event that occurs in society. An application for a replacement certificate due to loss can only be submitted by the party whose name is listed as the right holder in the relevant land book or another party who is the recipient of the right based on a PPAT deed or an excerpt of minutes of auction, deed, letter and power of attorney. If the right holder or beneficiary has died, an application for a replacement certificate can be submitted by his heirs by submitting a letter of proof as an heir.

Validity Of Business License Processing Through Online Single Submission Conducted By Notaries

Economic slowdown after the COVID-19 pandemic had a big impact on Indonesia, economic recovery was achieved through OSS, which in practice many businessmen request to be processed through Notary. The article aims to analyze the authority of Notaries in processing Business Licenses in OSS. This article uses a normative juridical method. Based on UUJN and PP of Business Licensing, there’s no Notary's authority on licensing arrangements. The basis for the Notary's is only power of attorney from the businessman, where this power of attorney, based on Article 1320 of the Civil Code, is void because it violates existing regulations. There are no sanctions for Notaries, but businessmen are subject to administrative sanctions if they do not fulfill their commitments. Notaries should not accept requests for licensing and focus on education.

DISCLOSURE OF MEDICAL RECORD INFORMATION TO GUARANTEE LEGAL ASPECTS OF CONFIDENTIALITY OF MEDICAL RECORDS IN TIRTAYASA PUSKESMAS

Background Medical Record according to Permenkes No.269/Menkes/Per/III/2008, Medical Record is a file that contains notes and documents about the patient's identity, examination results, treatment that has been given to the patient. Health facilities are responsible for protecting health information contained in medical records against possible loss, damage, falsification and unauthorized access. Maintaining information security, accuracy of information and ease of access to information are demands of health service organizations and health practitioners as well as authorized third parties. Meanwhile, parties who need information must always respect patient privacy. Overall, security, privacy, confidentiality and safety are devices that fortify information in medical records [1]. The purpose of this study was to determine the review of the release of medical record information in ensuring the legal aspects of the confidentiality of medical records at Kencana Hospital. Research method The research design used is descriptive research, which is a research method whose purpose is to present a complete picture of the social setting by describing a number of variables that are relevant to the problem and the unit under study among the phenomena being tested. This type of research is used to determine the process of providing medical record information and guaranteeing the legal aspects of medical record confidentiality at Kencana Hospital. The population in this study were all officers involved in the process of providing medical record information at Kencana Hospital which had 8 employees, which were divided into 3 medical record officers (1 head of medical records and 2 people served as distribution and retrieval officers), 2 people who handles related to insurance and 2 officers handles related to BPJS. In this study, the sample used was the party from the medical record unit, namely the medical record officer who has the authority in the process of providing patient medical information to a third party. The instruments used are Checklist Sheets and interview guidelines. In this study, the sampling used was purposive sampling technique because in sampling the authors considered certain things related to the research, The results of the research on StandardOperating Procedures related to providing patient medical information at the Kencana Hospital have an SOP. This SOP contains points for the process of releasing patient medical information, each point with a slightly different procedure depending on who the 3rd party is requesting. What is meant by 3rd parties here are patients, insurance companies, and legal institutions (courts). Each of these 3rd parties has made their respective procedures. The parties involved in the process of releasing patient medical information at Kencana Hospital are all medical record officers totaling15 people (8 officers in the filing section), (2 people in the distribution of medical record files), and (5 people in the registration section). The information released is in the form of a photocopy of a medical resume sheet. At Kencana Hospital, the only party who can decide on the release of patient medical information is the medical record officer. Kencana Hospital does not yet have special security related to the process of releasing patient medical information, but if a patient is represented in the process of requesting release of information, the representative must have a power of attorney from the patient concerned. If the request for release of information is not represented, the patient will be given a release approval form from the medical record unit. Suggestion It is better to make Standard Operating Procedures related to the Release of Patient Medical Information referring to the Regulation of the Minister of Health of the Republic of Indonesia Number 36 of 2012 concerning Medical Secrets and Guidelines for the Implementation and Procedures of Indonesian Hospital Medical Records issued by the Director General of Yanmed.

On clarifying the concept of "power of attorney" of artificial intelligence systems

On clarifying the concept of "power of attorney" of artificial intelligence systems

The Impact of Socioeconomic Status on the Presence of Advance Care Planning Documents in Patients With Acute Cervical Spinal Cord Injury.

Patients presenting with spinal cord injury (SCI) often times have notable deficits or polytrauma and may require urgent decision making for early management. However, their presentation may affect decision-making ability. Although advance care planning (ACP) may help guide spine surgeons as to patient preferences, the rate at which they are available and disparities in ACP completion are still not understood. The objective of this study was to evaluate disparities in the completion of ACP among patients with acute SCI. All patients presenting with cervical SCI to the emergency department at an urban, tertiary level I trauma center from 2010 to 2021 were identified from a prospective database of all consults evaluated by the spine service. Each patient's medical record was reviewed to assess for the presence of ACP documents such as living will, power of attorney, or advance directive. Community-level socioeconomic status was assessed using the Distressed Communities Index. Bivariable and multivariable analyses were performed. We identified 424 patients: 104 (24.5%) of whom had ACP. Patients with ACP were older (64.8 versus 56.5 years, P = 0.001), more likely White (78.8% versus 71.9%, P = 0.057), and present with ASIA Impairment Scale grade A SCI (21.2% versus 12.8%, P = 0.054), although the latter two did not reach statistical significance. On multivariable logistic regression, patients residing in at-risk communities were significantly less likely to have ACP documents compared with those in prosperous communities (odds ratio [OR]: 0.29, P = 0.03). Although patients living in distressed communities were less likely to complete ACP compared with those in prosperous communities (OR 0.50, P = 0.066), this did not meet statistical significance. Female patients were also less likely to have ACP (OR: 0.43, P = 0.005). Female patients and those from at-risk communities are markedly less likely to complete ACP. Attention to possible disparities during admission and ACP discussions may help ensure that patients of all backgrounds have treatment goals documented.

Legal Representation of Patients with Dementia in Long Term Care Settings

Introduction: Dementia is a neurodegenerative disease which affects cognitive, physical, and behavioural abilities. To date there is no effective disease-modifying treatment, so the course of disease is progressive [1]. Worsening cognition in advanced stages can impair the person’s mental capacity to make decisions. Consequently, advanced care planning (ACP) is an important aspect in dementia management [2]. Guardianship is an integral part of ACP where the patient legally appoints a trusted person to make best interest decisions for them should they lose capacity. As a result, this study aims to assess the legal representation of patients suffering from dementia. Method: Patients residing in all the nine dementia wards at Saint Vincent De Paul Residence (SVPR), were recruited (203 patients). A diagnosis of dementia is a requirement for admission to these wards. A data collection sheet was designed and included data on the patient’s demographics, MMSE scores and guardianship statuses. Data was collected retrospectively from the patient’s medical records and their caring medical team where documentation was lacking. The data collection period included September to October 2022. Results: Only 7 patients had a guardianship present (3%). The patients’ children (57.1%) were more likely to apply for guardianship, followed by the patients’ spouses (28.6%). The guardianship status was clearly documented in the doctors’ notes and next of kin (NOK) paper, together with the name and contact details of the guardians. 196 patients (97%) did not have guardianship. 5 of these had a power of attorney (POA) but the type was not specified. 190 patients had a relative or friend listed as the next of kin (NOK) and a patient had no legal guardian or NOK. Conclusion: Most patients with Dementia did not have formal legal representation like guardianship or valid POAs. However, the majority of NOK documented were in line with the legal definition of the responsible carer according to the MHA

A novel partnership for proactive person-centred anticipatory care in North Lanarkshire

Anticipatory Care is a shift from reactive, fragmented, episodic care to proactive, personalised and coordinated team based care that starts with what matters to the individual and takes an enablement and strength based approach. However in a post Covid-19 landscape many primary care teams are challenged to deliver proactive care for the growing number of people with frailty who will benefit from the approach. &#x0D; A novel collaborative approach was co-designed with primary care teams, patients and carers in one locality. Information from GP records and the electronic Frailty Index was used to identify individuals with escalating levels of frailty. In addition, professionals could identify individuals opportunistically. Prior to the pandemic, Health Visitors gathered information and performed clinical assessments at home and discussed issues such as Power of Attorney and Anticipatory Care Planning (ACP). The workforce disruption from the pandemic was a catalyst to test new workforce roles. The locality engaged an advocacy service partner to increase capacity for authentic person centred multi disciplinary team (MDT) care for older people with frailty. Other core members of the MDT are GP, geriatrician and pharmacist with support as required from allied health professionals, social care, dietician, community mental health team and third sector.&#x0D; The approach is goal--orientated ensuring the patient, their wishes and their family or carer remain the primary focus (Steele Gray et al, 2020). The advocacy worker supports the patient through a self assessment process before representing the patient within the MDT discussion, ensuring independent advocacy and support at each stage of the process and enabling the MDT to formulate interventions that are in keeping with the patient’s wishes and priorities for their health. Interventions range from polypharmacy reviews to care packages, referrals to other professionals and to social prescribing supports. Following the MDT the patient receives a phone call from the advocacy worker, outlining the proposed interventions and ensuring they are empowered to express their opinion and wishes. Thus the patient remains in control and the team avoids a paternalistic therapeutic approach (Dumez and Pomey, 2019).&#x0D; Between October 2019 and December 2021, 106 patients were discussed by the MDT. Median age was 78 (range 58 – 101) years, 58% were female and 73% were identified using routine GP data. Seventy had a home assessment and multifactorial interventions, the remainder had an ACP to share their wishes about future care. &#x0D; &#x0D; An enabler was the use of Microsoft Teams platform. Conducting MDT’s virtually allows seamless information sharing in real time for accurate and informed care planning despite health, social care and the third sector operating separate electronic systems.&#x0D; The advocacy service is now seen as a key partner in the MDT. Working in a transdisciplinary manner helped overcome service pressures. Extending roles outwith normal professional boundaries and across sectors creates capacity for managing frailty, ensures safe, effective and person centred care and enables relational practice and reciprocal learning (Batorowicz and Shepherd, 2008). The novel collaborative approach is now being rolled out across other localities.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

POWER OF ATTORNEY FACTORS AND CONDITIONS INFLUENCING ELDER FAMILY FINANCIAL EXPLOITATION

Abstract Approximately 16% of older adults worldwide experience some form of elder abuse including elder family financial exploitation (EFFE), the unlawful transfer and theft of funds and property perpetrated by a family member. Power of Attorney (POA) arrangements, when constructed and executed properly, can be critical tools for protecting against such exploitation. This national research study examined family reports of EFFE using the Bronfenbrenner Ecological Framework to classify risk factors within the POA arrangement. Interviews were carried out with 31 family members within 24 families that had experienced EFFE. Using constructivist grounded theory analysis methods, the following themes related to risk factors were noted across EFFE stories about professionals involved in the EFFE situations: 1) Conflict of interest between attorneys and POA agents, 2) A perceived lack of competence of consulting attorneys; and 3) A lack of transparency around POA arrangements. Policy and education implications include the need to create legal requirements for transparency reporting and/or registration for POAs, strengthening legal ethics and EFFE training, and providing public education to families about the POA process and how to locate appropriately trained legal professionals.

PLANNING AHEAD FOR POSTHOSPITALIZATION DISCHARGE NEEDS AMONG OLDER ADULTS

Abstract Frequently hospitalized older adults require assistance at discharge – either with transfer to a skilled nursing facility (SNF) or additional support at home. Our research has demonstrated that older adults can effectively plan ahead for their discharge needs (e.g., selecting SNFs) prior to hospitalization but some chose not to. Very little is known about what motivates older adults to plan. We sought to identify what variables impact older adults’ post-hospitalization planning. We surveyed a cohort of non-hospitalized adults age 65+ who received PlanYourLifespan.org (PYL), a tool to help older adults plan for their post-hospitalization needs, and then completed follow-up surveys at one month and every 6 months thereafter. Surveys inquire about their post-discharge plans if they were to be hospitalized, specifically rehabilitation/caregiver preferences. Multivariate logistic regression models adjusted for baseline hospitalization decision-making, sex, race, self-efficacy, living status, cognitive impairment, and PYL use. 293 subjects were enrolled (mean 73.5 yrs,40.4% non-White;12 mo. retention rate 94.5%). Subjects were more likely to have plans if they had increased chronic conditions (OR 1.23;p&amp;gt;0.05,1.02-1.47), increased medications (OR 1.15;p&amp;lt; 0.01,1.07-1.25), power of attorney (OR 1.84;p&amp;lt; 0.05,1.01-3.38), and used PYL (OR 2.61;p&amp;lt; 0.01,1.45-4.72). Subjects were more likely to have plans if they had higher medical complexity (OR 1.13 [p&amp;lt; 0.05, 1.03-1.24]), limited health literacy (OR 3.13 [p&amp;lt; 0.05, 1.25-7.81]), and used the PYL website (OR 1.72 [P&amp;lt; 0.05,1.00-2.93]) when asked about planning for future post-hospitalization requiring help in the home. Higher medical complexity, limited health literacy, and use of the planning website were associated with increased hospitalization discharge planning.

BECOMING INCLUSIVE: A NECESSARY PURSUIT FOR SUPPORTING FAMILY CAREGIVERS IN HOSPITAL CARE

Abstract Given advances in medicine and technology, shorter hospital stays, and a shrinking health care workforce, an increasing number of older adults are relying on family caregivers for support during and after hospital care. Yet, our healthcare system is often unresponsive to the needs of family caregivers. Recent consensus recommendations including the National Strategy on Family Support encourages health systems to include family caregivers in care processes of older adults. This presentation will report interview and community advisory board findings from a qualitative descriptive study of N=24 stakeholders consisting of hospitalized older adults (n=4), family caregivers (n=6), healthcare providers (n=9), and health policymakers (n=5). The goals of the study were to identify and describe existing barriers and facilitators to the inclusion of family caregivers in older adult’s hospital care. Of the participants, 87% were female and from the Midwest region, and all were Caucasian. The average age was 56 years. The resulting themes from this exploration demonstrated that inclusion of family caregivers in hospital care is influenced by personal factors of both the caregiver and the provider (caregiver availability, health literacy, education, values/priorities), interpersonal skills between these two parties (communication style and methods), hospital environment/resources (accessibility, comfortability, staffing, documentation), and social climate/policy (Covid-19 Restrictions, HIPAA, Power of Attorney). Findings from this study can be used to develop or adapt healthcare system policies and practices, fulfilling Outcome 2.1 of the National Strategy on Family Support’s recommendation for recognizing family caregivers as essential members of the care team.

Legal Dynamics of Limited Liability Companies: Unveiling the Power of Commissioners and Shareholders to Take Legal Action Against Directors' Negligence

The Limited Liability Company (LLC) is characterized by its distinct juridical entity, effectively segregating its management group from shareholders. Operating as a business entity, the primary goal of an LLC is profit generation. Functioning as a corporate legal entity with legal personality, an LLC comprises three key organizational components: the General Shareholders’ Meeting, Directors, and Commissioners. Directors, or the Board of Directors (BOD), bear the responsibility of managing and representing the LLC both within and outside the legal realm. The position of BOD is mandated to be occupied by a natural person, or 'naturlijk person,' either as a single individual (Director) or collectively by two or more individuals (Board of Directors). Despite a stringent selection process for board positions, the inherent nature of directors as natural persons introduces the possibility of intentional or negligent errors in management, potentially leading to financial losses. In the face of such negligence, the pertinent question arises: can a commissioner (Board of Commissioners) and/or shareholders initiate legal action against a director or BOD, whose legal standing is as the company’s representative? To address this query, a comprehensive library research initiative is undertaken, focusing on the analysis of Article 97 and Article 98 of the Limited Liability Company’s legal statutes. This examination aims to elucidate the viable courses of action that can be pursued against the company in the event of directorial negligence. The research findings reveal that specific commissioners and/or shareholders, in the absence of a director's power of attorney, are granted the authority by the LLC’s legal statutes to initiate legal proceedings against the director or board of directors in a court of law.