4/9/2023 0 Comments Difficult decisions![]() The ‘fast and frugal’ heuristic was more accurate in predicting myocardial infarctions, and had the added advantages of being both memorable and speedy. The Heart Disease Predictive Instrument was used to guide physicians' decisions, and contained 50 probabilities that could be checked against symptoms it required the use of a pocket calculator. 11 This heuristic was developed as an alternative to a decision guide for managing patients with chest pain in some US hospitals, and deciding who needed to be admitted to a coronary care unit and who not. As figure 1 shows, a complex decision may be simplified through the use of heuristic principles. 10, 14 Such heuristics are ‘fast’ because they do not involve much computation and ‘frugal’ because they only search for part of the information needed. 13Ī commonly cited ‘fast and frugal’ heuristic is illustrated in figure 1. They need to be made transparent and examined critically. 10–12 The disadvantages are that using rules of thumb in practice is subject to cognitive bias and may perpetuate erroneous judgements heuristics are therefore controversial. The advantages of using heuristics include precision, speed, accessibility and transparency-they can surpass the accuracy of more information-greedy decision aids and they are easy to use in a care setting, especially for those working under time constraints. 10 This means they differ from guidelines. Heuristics are simple decision strategies, which base outcomes on only a few relevant predictors. 9 As a result of these limitations, there is a paucity of evidence to guide decision-making therefore, application of ‘rules of thumb’ or heuristics may have an important role in end of life dementia care. There are both practical and ethical constraints, with regard to conducting RCTs in this area, and these are well documented in the palliative care literature. Many of the difficult decisions made for people with dementia cannot be guided by robust evidence from randomised controlled trials (RCT), because they are yet to be carried out, if indeed they are possible. Since its withdrawal, there is felt to have been a further decline in confidence among practitioners. Previously, the Liverpool Care Pathway in England offered some structure for practitioners to deliver end of life care. 5 Recently, new guidance has been released, 6 but this only focuses on care at the very end of life and does not encompass the needs of people with dementia. 3 Although an European consensus is emerging for dementia, 4 in England, the National Institute for Health and Care Excellence (NICE) guidance on end of life care is mainly targeted at patients with cancer. 2Įven practitioners experienced in palliative care and dementia care report a lack of confidence in meeting the needs of someone with dementia nearing the end of life. The need for end of life care is growing as the population ages but the evidence base to guide those providing such care to individuals who do not have cancer is thin. 1 End of life care is therefore rapidly becoming one of the major priorities for practitioners in this field. On the other hand, single planning always had a barrier of individual possibilities, and it has only limited resources and ideas.The median survival period following a diagnosis of dementia is three and a half years. Group discussions help for better brainstorming and help to tackle the situation very effortlessly. Because, when we are discussing a serious matter in front of a group we can easily solve it with numerous effective ways. Question 2:- Which is easier, making a decision by oneself or making a decision after a group discussion?Īnswer:- In my opinion, decisions that are more fruitful are after group discussions compared to individual decisions. ![]() ![]() These decisions may help individuals for better planning and understandings. It’s mostly related to their day-to-day life, diet, their job, monthly budget, education of their children, their medication, and many more. Once they take any decisions, they review them again. ![]() Follow ups of Describe a difficult decision that you once made Question 1:- What decisions do people generally make in their daily life?Īnswer:- In daily life, people can take plenty of decisions. But fortunately or unfortunately, it may differentiate. Because everyone had so many dreams about their marriage and followed days, even I also had. I strongly believe nobody can’t take such decisions in their life. Still, I felt it was one of the outstanding decisions I ever made. As per the planned date, I flew to the Sultanate of Oman. Still, it was one of the most drastic decisions I have ever made.
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