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Dementia (London). 2018 Nov 23:1471301218814641. doi: 10.1177/1471301218814641. [Epub ahead of print]

Family caregivers' involvement in decision-making processes regarding admission of persons with dementia to nursing homes.

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Faculty of Health Sciences, Department of Health and Care Sciences and Centre for Care Research North, UiT The Arctic University of Norway, Tromso, Norway.
Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway.


The current Western health policy of ageing in place relies on a triad collaboration among patients, healthcare service providers and family caregivers. Such collaborations presuppose involvement in a vague juridical landscape. This article explores family caregivers' experiences with involvement in and influence on nursing home decision-making processes for persons with dementia. The data consist of 12 in-depth interviews with family caregivers. Using positioning theory, we demonstrate how family caregivers strive to balance their assumed duty to care for the person with their needs to care for themselves. Their involvement (or non-involvement) in the complex decision-making process is demonstrated through the following seven positions: (1) self-condemning determiner, (2) dominant, (3) proponent, (4) saluting, (5) pending, (6) prisoner, and (7) stooge. Furthermore, we discuss why expedient positions are more available for some individuals and the consequences of family caregivers' various positions on the healthcare policy aims of collaboration and equal healthcare services.


admission to nursing homes; decision-making processes; dementia; family caregivers; home-based care; involvement; positioning


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