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Centre for Policy on Ageing | |
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Everyday decision-making in dementia
— findings from a longitudinal interview study of people with dementia and family carers | | Author(s) | Kritika Samsi, Jill Manthorpe |
| Journal title | International Psychogeriatrics, vol 25, no 6, June 2013 |
| Publisher | Cambridge University Press, June 2013 |
| Pages | pp 949-961 |
| Source | journals.cambridge.org/ipg |
| Keywords | Dementia ; Family care ; Independence ; Consumer choice ; Rights [elderly] ; Attitude ; Longitudinal surveys. |
| Annotation | Exercising choice and control over decisions is central to quality of life. The Mental Capacity Act 2005 (England and Wales) provides a legal framework to safeguard the rights of people with dementia to make their own decisions for as long as possible. The impact of this on long-term planning has been investigated although everyday decision-making in people's own homes remains unexplored. Using a phenomenological approach, interviews were conducted with 12 dyads (one person with dementia + one carer) four times over one year to ascertain experience of decision-making, how decisions were negotiated and how dynamics changed. Qualitative interviews were conducted in people's own homes, and thematic analysis was applied to transcripts. Study findings showed that respecting autonomy, decision-specificity and best interests underlayed most everyday decisions in this sample. Over time dyads transitioned from supported decision-making, where person with dementia and carer made decisions together, to substituted decision-making, where carers took over much decision-making. Points along this continuum represented carers' active involvement in retaining their relative's engagement through providing cues, reducing options, using retrospective information and using the best interests principle. Long-term spouse carers seemed most equipped to make substitute decisions for their spouses, while adult children and friend carers struggled with this. Carers may gradually take on decision-making for people with dementia. This can bring with it added stresses, such as determining their relative's decision-making capacity and weighing up what is in their best interests. Practitioners and support services should provide timely advice to carers and people with dementia around everyday decision-making and be mindful how abilities may change. (JL). |
| Accession Number | CPA-130531222 A |
| Classmark | EA: P6:SJ: C3: WYC: IKR: DP: 3J |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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