The Impact of a Shared Decision-Making Training Program on Dementia Care Planning in Long-Term Care

Mariani, Elisabetta; Chattat, Rabih; Ottoboni, Giovanni; Koopmans, Raymond T.C.M.; Vernooij‐Dassen, Myrra; Engels, Yvonne

doi:10.3233/jad-180279

Cited by 14 publications

(29 citation statements)

References 46 publications

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“…Healthcare research has established that involving individuals in shared decision-making by encouraging active participation and enhanced communication, can provide individuals with more control over their care, improves the ability to make informed choices and allows them to participate knowledgeably in treatment decisions ( De Wilde et al, 2017 ; Elwyn et al, 2010 ). Shared decision-making in dementia care is a relatively new concept ( Mariani, 2019 ) and has more often been implemented in terms of care planning and end-of-life care ( Gjerberg et al, 2015 ), though more recently research is exploring shared decision-making during the diagnostic process ( De Wilde et al, 2017 ). As captured in our statements, patient–clinician conversations during the workup require sensitivity, and care should be taken when delivering updates on ongoing assessments and when delivering diagnoses.…”

Section: Resultsmentioning

confidence: 99%

Receiving a diagnosis of young onset dementia: Evidence-based statements to inform best practice

O’Malley¹,

Parkes

Campbell

et al. 2020

Dementia

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Introduction Better understanding of patient experience is an important driver for service improvements and can act as a lever for system change. In the United Kingdom, the patient experience is now a central issue for the National Health Service Commissioning Board, clinical commissioning groups and the providers they commission from. Traditionally, dementia care in the United Kingdom has focused predominantly on the individual experience of those with late onset dementia, while the voice of those with young onset dementia has been, comparatively, unheard. This study aims to improve the understanding of the personal experience of younger people undergoing investigation for dementia. Methods A modified Delphi approach was undertaken with 18 younger people with dementia and 18 supporters of people with young onset dementia. Questions were informed by a scoping review of the literature (O’Malley, M., Carter, J., Stamou, V., Lafontaine, J., & Parkes, J. (2019a). Receiving a diagnosis of young onset dementia: A scoping review of lived experiences. Ageing & Mental Health, 0(0), 1-12). Summary individual statements were refined over two rounds to a final list of 29 key statements. Results Twenty-seven of these statements were rated as absolutely essential or very important and included (1) for the general practitioner to identify dementia in younger people, (2) clinicians should be compassionate, empathic and respectful during the assessment and particularly sensitive when providing information about a diagnosis, and (3) remembering that receiving the diagnosis is a lot to absorb for a person with dementia and their supporter. Statistical analyses found no difference in the scoring patterns between younger people with dementia and supporters, suggesting similar shared experiences during the diagnostic process. Conclusion Understanding the uniquely personal experience of young people going through the process of diagnosis for dementia is essential to provide person-centred, needs-led, and cost-effective services. Patient’s values and experiences should be used to support and guide clinical decision-making.

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Section: Resultsmentioning

confidence: 99%

Receiving a diagnosis of young onset dementia: Evidence-based statements to inform best practice

O’Malley¹,

Parkes

Campbell

et al. 2020

Dementia

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“…Interventions aimed at improving communication and collaboration between staff, and family members can promote positive and constructive relationships and interpersonal connections (Barken & Lowndes, 2018; Haesler, Bauer, & Nay, 2010), and can foster a relational approach to care—characterised by open communication, mutual understanding and trust (Barken & Lowndes, 2018). In a recent study examining the effect of a staff communication skills training programme in the implementation of shared decision‐making with residents and families in the care planning process, the authors reported an improvement in residents’ care plans (Mariani et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Strategies to facilitate shared decision‐making in long‐term care

Cranley

Slaughter

Caspar

et al. 2020

Int J Older People Nursing

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Aim The aim of this study was to explore shared decision‐making among residents, their families and staff to determine relevant strategies to support shared decision‐making in long‐term care (LTC). Background Meaningful engagement of long‐term care home (LTCH) residents and their families in care decisions is key in the provision of quality of care. Shared decision‐making is an interprofessional approach to increasing resident and family engagement in care decisions which can lead to higher quality decisions, more relevant care interventions and greater resident, family, and staff satisfaction. Despite these advantages, shared decision‐making has not been widely implemented in practice in LTC. Methods The study took place in one LTCH in Toronto, Ontario, Canada. A qualitative descriptive design was used to explore how residents, family members and staff described how they collaborate when making decisions concerning resident care, and their perceptions of facilitators and challenges to a collaborative approach to decision‐making. Individual interviews were conducted with nine participants: residents, families and staff. Data were analysed using content and thematic analysis. Findings Four main themes that described resident, family and staff perspectives of shared decision‐making were as follows: (a) oral communication pathways for information sharing; (b) supporting resident decision‐making autonomy; (c) relational aspects of care facilitate shared decision‐making; and (d) lack of effective communication creates barriers to shared decision‐making. Conclusion As the demand for LTC continues to increase, it is crucial that healthcare providers engage in collaborative, relational practices that foster high‐quality resident care. While a relational approach to care can facilitate shared decision‐making, there are opportunities to further cultivate shared decision‐making in LTCHs through more effective communication and collaboration. Implications for practice Understanding how information is shared and decisions are made can facilitate shared decision‐making in LTCHs. The strategies identified from this study could be further co‐developed and implemented in LTCHs.

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“…In addition to integrating the relevant professional departments, caregivers and patients on both sides should be viewed as a dyad, and equally provided with medical professional assessments, diagnosis, treatment, or transfer simultaneously, in order to maintain the caregivers’ health and to provide care-related knowledge and skills. The care team (e.g., physician, community and home care nurse) could also design the decision sharing model to help the caregivers choose the most appropriate long-term care service items to improve the care of PWD, reducing the burden on caregivers [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

The Needs and Utilization of Long-Term Care Service Resources by Dementia Family Caregivers and the Affecting Factors

Chang

Ming²,

Chang

et al. 2020

IJERPH

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This study was to evaluate the utilization of long-term care service resources by caregivers of patients with dementia (PWD) and to determine affecting factors. In this cross-sectional study, a total of 100 dyads were enrolled and caregivers responded to the questionnaires. We found 40% of caregivers not using any care resources. Between those caregivers using and not-using care resources, we found differences (p < 0.05) in their health status and living conditions; the difference (p < 0.05) was also found in patients’ behavior and psychological symptoms of dementia (BPSD). The frequency of BPSD (OR = 1.045, p = 0.016, 95% CI = 1.001–1.083) and the living conditions (OR = 3.519, p = 0.007, 95% CI = 1.414–8.759) were related to their use of care resources. Particular BPSDs, such as anxiety or restlessness, throwaway food, aggressive behavior, tearing of clothes, and sexual harassment of patients were related to the caregivers’ use of care resources (p < 0.01). Health professionals have to evaluate the patients’ BPSD and identify the caregivers’ essential needs. Individualized medical care and BPSD-related care resources should be provided for patients and caregivers for taking off their care burden and improving patient care.

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The Impact of a Shared Decision-Making Training Program on Dementia Care Planning in Long-Term Care

Abstract: The involvement of residents and family caregivers in care planning contributed to an improvement of the residents' care plans, but it did not have an effect on family caregivers and staff outcomes.

Cited by 14 publications

References 46 publications

Receiving a diagnosis of young onset dementia: Evidence-based statements to inform best practice

Receiving a diagnosis of young onset dementia: Evidence-based statements to inform best practice

Strategies to facilitate shared decision‐making in long‐term care

The Needs and Utilization of Long-Term Care Service Resources by Dementia Family Caregivers and the Affecting Factors

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