The surrogate's experience during treatment decision-making.

PURPOSE: To explore the experiences, thoughts, and feelings of surrogates making decisions for older adults. To identify nursing practices perceived as helpful to surrogates. SAMPLE: Eleven surrogate decision-makers. METHOD: Qualitative. Semi-structured interviews/descriptive data used to enrich a larger study. FINDINGS: Four main themes were identified that described the surrogates' experiences: Contextualizing the decision Actualizing agency Reviewing and resolving Transcending CLINICAL IMPLICATIONS: Three paradigm cases describe caregiving, protecting, and trusting response patterns of surrogates. Surrogates found decision-making an evolving and difficult process. Nurses can be more helpful to surrogates by giving them more opportunities to ask questions, solicit information, express emotions and obtain comfort and support.