How people with dementia and their families decide about moving to a care home and support their needs: development of a decision aid, a qualitative study.
How people with dementia and their families decide about moving to a care home and support their needs: development of a decision aid, a qualitative study.
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DOI：
10.1186/s12877-016-0242-1
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发表时间：
2016-03-21
期刊：
影响因子：
4.1
通讯作者：
Cooper C
中科院分区：
文献类型：
--
作者：
Lord K;Livingston G;Robertson S;Cooper C
痴呆症患者和他们的亲属发现痴呆症患者住在护理院的决定很困难。我们采访了20名痴呆症患者或家庭照顾者，以设计一个决策辅助工具。决策者平衡了留在熟悉的地方，家人希望他们留在家里，减少风险和对照顾者和痴呆症患者身体健康的影响等相互竞争的优先事项。患有痴呆症的人经常抱怨他们缺乏自主权，因为在洞察力和判断力受损后做出了关于护理之家移动的决定。家庭咨询通常有助于照顾者，但有时会加剧紧张关系。如果有直接的专业支持，则表示赞赏。有必要为医疗保健专业人员，以促进这些对话围绕决策，并包括更多的路标到其他组织。需要医疗保健专业人员协助决策。这应该详细说明痴呆症患者及其护理人员可能发生的变化，可能的资源和替代方案，并有助于促进与更广泛的家庭进行讨论;进一步的研究将开发和测试一种工具，以促进有关护理需求的决策。
People with dementia and their relatives find decisions about the person with dementia living in a care home difficult. We interviewed 20 people with dementia or family carers around the time of this decision in order to design a decision-aid. Decision-makers balanced the competing priorities of remaining somewhere familiar, family’s wish they remain at home, reduction of risk and effects on carer’s and person with dementia’s physical health. The person with dementia frequently resented their lack of autonomy as decisions about care home moves were made after insight and judgment were impaired. Family consultation usually helped carers but sometimes exacerbated tensions. Direct professional support was appreciated where it was available. There is a need for healthcare professionals to facilitate these conversations around decision-making and to include more than signposting to other organisations. There is a need for a healthcare professional facilitated decision-aid. This should detail what might change for the person with dementia and their carer, possible resources and alternatives and assist in facilitating discussion with the wider family; further research will develop and test a tool to facilitate decision making about place of care needs.