Upholding Due Diligence: Advocating for a Patient who Appeared to be Unrepresented

Palliative care teams frequently care for older adults living with serious illness who are prone to becoming “unrepresented” (i.e., without decision-making capacity and without advance directives or surrogate decision makers) as loved ones also age and become unavailable to help. The number of people who are unrepresented is at risk of increasing as the population ages. Individual clinicians and health care systems at large may have different thresholds for declaring a patient as unrepresented, placing them at risk for both overtreatment and undertreatment in the medical setting.

This Interprofessional Grand Rounds will explore the vulnerabilities of patients who are labeled as unrepresented and the importance of interprofessional collaboration alongside standardized protocols for identifying decision-makers. By the end of the case presentation, learners will appreciate the unique requirements for due diligence in caring for patients who appear to be unrepresented.

Learning outcomes:

1. To identify the vulnerabilities of patients who are labeled as unrepresented. 
2. To promote the importance of standardized protocols and interprofessional collaboration in determining if patients are truly unrepresented.