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Patient Educ Couns. 2017 Jul;100(7):1329-1337. doi: 10.1016/j.pec.2017.01.024. Epub 2017 Feb 4.

Recognizing decision needs: first step for collaborative deliberation in dementia care networks.

Author information

1
Research Group Innovating with Older Adults, Centre of Expertise in Health Care and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands. Electronic address: lm.groen-vande.ven@windesheim.nl.
2
Research Group Innovating with Older Adults, Centre of Expertise in Health Care and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands.
3
Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA.
4
Care Organization IJssel-Vecht, Zwolle, The Netherlands; Department of Nursing Home Medicine and EMGO Institute for Health and Care Research, Free University Medical Centre Amsterdam, The Netherlands.
5
Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Department of Primary Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Abstract

OBJECTIVE:

This study describes the process elements of decision-making for dementia, in order to enrich a model to facilitate shared decision-making for professionals working with people with dementia and their informal caregivers.

METHODS:

We performed a qualitative study based on secondary analysis of 117 interviews from 23 care networks consisting of people with dementia, their informal caregivers and professionals. Findings were compared to an existing model of collaborative deliberation.

RESULTS:

We made an enhancement to the existing collaborative deliberation model, to include: (1) constructive network engagement, (2) recognizing the need for a decision, (3) defining what to decide on, (4) developing alternatives, (5) constructing preferences through deliberation and trying out alternatives, (6) multiple preference integration, and (7) evaluating decision-making.

CONCLUSION:

In describing the process elements of decision-making in dementia, this empirical study proposes a modification of the model of collaborative deliberation for the context of dementia care. The adaptation highlights the special attention needed to recognize and define what to decide on, try out alternatives, and handle conflicting interests and preferences.

PRACTICE IMPLICATIONS:

Professionals should be attentive to mark the start of the decision-making process and work with participants towards a shared view on the pressing matters at hand.

PMID:
28238420
DOI:
10.1016/j.pec.2017.01.024
[Indexed for MEDLINE]

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