scholarly journals Exploring shared care plans for older people regarding fulfillment of policy requirements and shared decision making - A qualitative study

2021 ◽  
Vol 9 (2) ◽  
pp. 154-183
Author(s):  
Anna Condelius ◽  
Magdalena Andersson
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Social Services ◽  
Planning Process ◽  
Shared Care ◽  
Care Planning ◽  
Shared Decision ◽  
Next Of Kin ◽  
Care Plans

The aim was to explore the documentation in shared care plans regarding the fulfilment of policy requirements and shared decision-making. The sample consists of 15 shared care plans established for older people in Sweden. The analysis was performed using directed content analysis. The requirements in the Swedish law and the 15 indicators of shared decision making (SDM) in the Multifocal Approach to the Sharing in SDM inventory was used to define the main categories. The policy requirements were fulfilled to a varied extent. All the care plans were established in collaboration between the municipality and the county council, but social services were not represented in six of them. The older person and next of kin were present at 14 of the care planning meetings. The individual’s agreement to the establishment was documented in ten of the plans but how and what the person had agreed to was not specified further. The headings focused at the policy requirements and did not support a care planning process, or a documentation based on SDM. Six out of 15 indicators of SDM were reflected. The decision-making process needs to be acknowledged more in the process of establishing shared care plans for older people.

scholarly journals SHARED DECISION MAKING IN DEMENTIA CARE PLANNING: INVOLVING FAMILY CAREGIVERS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 667-667
Author(s):  
M. Vernooij-Dassen ◽  
E. Mariani ◽  
Y. Engels ◽  
R. Chattat
Keyword(s):  
Decision Making ◽  
Family Caregivers ◽  
Shared Decision Making ◽  
Dementia Care ◽  
Care Planning ◽  
Shared Decision

scholarly journals 023 PP: INVOLVING PATIENTS AND CARERS IN RESEARCH: THE EXPERIENCE OF OLDER PEOPLE IN THE SHARED DECISION-MAKING PROCESS IN ADVANCED KIDNEY CARE a

BMJ Open ◽  
2017 ◽  
Vol 7 (Suppl 2) ◽  
pp. bmjopen-2017-016492.41
Author(s):  
N Thomas ◽  
K Jenkins ◽  
S Datta ◽  
R Endacott ◽  
J Kent ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Decision Making Process ◽  
Shared Decision

scholarly journals Too much medicine in older people? Deprescribing through shared decision making

BMJ ◽  
2016 ◽  
pp. i2893 ◽  
Author(s):  
Jesse Jansen ◽  
Vasi Naganathan ◽  
Stacy M Carter ◽  
Andrew J McLachlan ◽  
Brooke Nickel ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Shared Decision

Shared decision-making preferences and pain characterization in patients with cancer.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 30-30 ◽  
Author(s):  
Jeannine M. Brant ◽  
Carrie Tompkins Stricker ◽  
Alison Petok ◽  
Regina Sih-Meynier ◽  
Debra Wujcik
Keyword(s):  
Decision Making ◽  
Cancer Pain ◽  
Shared Decision Making ◽  
Breakthrough Pain ◽  
Activity Level ◽  
Shared Decision ◽  
Patients With Cancer ◽  
Care Plans ◽  
Pain Outcomes ◽  
Pain Care

30 Background: Cancer pain prevalence is high (52%-77%) with breakthrough pain flares and end-of-dose failure adding to patient suffering and increased health care utilization. Shared decision-making (SDM), incorporating patient-stated preferences, goals, and concerns, can foster comprehensive pain assessment (CPA) and improve pain outcomes. Methods: This study will evaluate SDM and CPA in patients with cancer to manage chronic and breakthrough pain. Eligible patients have pain or are taking opioids to manage chronic cancer pain. Patients complete a tablet-based survey at enrollment to record baseline pain and activity levels, pain flare severity and length, end-of-dose pain, and SDM preferences. Results are presented on an electronic dashboard and the provider and patient collaboratively establish a pain care plan. The effectiveness of SDM on pain outcomes will be measured with the Pain Care Quality Survey. Results: Pain characterization is described for the first 43 patients enrolled, of which 42% (n=18) desire to share decision-making with the provider, while 35% (n=15) prefer to make the final decision after considering provider input. Patients are 57% (n=26) female with a mean age of 56 (range 20-93); baseline mean pain scores were 5.4, and overall distress scores were 5.43, (scale 0-10); 91% had a pain flare in the last seven days with mean severity of 5.53; 72% of flares lasted longer than 30 minutes. All patients had end-of-dose pain. Less than half (42%) have restricted activity and 23% manage self-care but cannot work. Participants reported incident pain associated with certain activity (63%) as well as insidious pain not associated with activity (65%). Enrolled patients selected 143 pain descriptors: burning (16), achy (24), sharp and stabbing (21), pins and needles (15), cramping (14) radiating (14), intermittent (19), and continuous (20). Conclusions: The majority (77%) of patients desire SDM. Although most patients were already taking opioids at presentation, they had moderate pain and distress, frequent flares and end of dose pain, and limitations on activity level due to the pain. Baseline pain characterization with a drill down CPA offers opportunity to use SDM to develop effective pain care plans and measure outcomes. Clinical trial information: NCT03304145.

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

2018 ◽  
Vol 64 (4) ◽  
pp. 1123-1135 ◽  
Author(s):  
Elena Mariani ◽  
Rabih Chattat ◽  
Giovanni Ottoboni ◽  
Raymond Koopmans ◽  
Myrra Vernooij-Dassen ◽  
...  
Keyword(s):  
Decision Making ◽  
Training Program ◽  
Shared Decision Making ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Planning ◽  
Shared Decision ◽  
Term Care ◽  
The Impact

scholarly journals Supporting shared decision making for older people with multiple health and social care needs: a realist synthesis

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Frances Bunn ◽  
Claire Goodman ◽  
Bridget Russell ◽  
Patricia Wilson ◽  
Jill Manthorpe ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Social Care ◽  
Realist Synthesis ◽  
Shared Decision ◽  
Care Needs ◽  
Health And Social Care ◽  
Multiple Health

Engaging older people in decisions about their healthcare: the case for shared decision making

2012 ◽  
Vol 22 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Joanne Lally ◽  
Ellen Tullo
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Clinical Practice ◽  
Healthcare Professional ◽  
Older People ◽  
Shared Decision Making ◽  
Clinical Condition ◽  
Decision Making Process ◽  
Shared Decision ◽  
Risks And Benefits

SummaryShared decision making in clinical practice involves both the healthcare professional, an expert in the clinical condition and the patient who is an expert in what is important to them. A consultation involving shared decision making enables an examination of the options available, consideration of the risks and benefits whilst incorporating the values of the patient into the decision making process. A decision is aimed at, which is both clinically appropriate and is congruent with the patient's values.Older people have been shown to value involvement, to varying degrees, in decisions about their care and treatment. The case of atrial fibrillation shows the opportunities for, and benefits of, sharing with older people decision making about their healthcare.

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