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Type: Journal article
Title: Family meetings for older adults in intermediate care settings: the impact of patient cognitive impairment and other characteristics on shared decision making
Author: Milte, C.
Ratcliffe, J.
Davies, O.
Whitehead, C.
Masters, S.
Crotty, M.
Citation: Health Expectations, 2015; 18(5):1030-1040
Publisher: Wiley
Issue Date: 2015
ISSN: 1369-6513
Statement of
Catherine M. Milte, Julie Ratcliffe, Owen Davies, Craig Whitehead, Stacey Masters and Maria Crotty
Abstract: Background: Clinicians, older adults and caregivers frequently meet to make decisions around treatment and lifestyle during an acute hospital admission. Patient age, psychological status and health locus of control (HLC) influence patient preference for consultation involvement and information but overall, a shared‐decision‐making (SDM) approach is favoured. However, it is not known whether these characteristics and the presence of cognitive impairment influence SDM competency during family meetings. Objective: To describe meetings between older adults, caregivers and geriatricians in intermediate care and explore patient and meeting characteristics associated with a SDM communication style. Methods: Fifty‐nine family meetings involving geriatricians, patients in an intermediate care setting following an acute hospital admission and their caregivers were rated using the OPTION system for measuring clinician SDM behaviour. The geriatric depression scale and multidimensional HLC scale were completed by patients. The mini‐mental state exam (MMSE) assessed patient's level of cognitive impairment. Results: Meetings lasted 38 min (SD 13) and scored 41 (SD 17) of 100 on the OPTION scale. Nine (SD 2.2) topics were discussed during each meeting, and most were initiated by the geriatrician. Meeting length was an important determinant of OPTION score, with higher SDM competency displayed in longer meetings. Patient characteristics, including MMSE, HLC and depression did not explain SDM competency. Conclusion: Whilst SDM can be achieved during consultations frail older patients and their caregivers, an increased consultation time is a consequence of this approach.
Keywords: Decision making; frail elderly; health services for aged; physician-patient relations
Rights: © 2013 John Wiley & Sons Ltd. All Health Expectations articles are published under the terms of the Creative Commons Attribution License (CC BY) which allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed. Copyright on any research article published by a Wiley Open Access journal is retained by the author(s).
RMID: 0030098653
DOI: 10.1111/hex.12076
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Appears in Collections:Public Health publications

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