Ways of Decision-Making Used in the Care Decisions of Individuals with Dementia
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Abstract
An understanding of the ways that rural community dwelling individuals with dementia (IWDs) are, and prefer to be, involved in their decision-making could help caregivers maximize IWDs’ contribution to their decisions and could thus improve their care. This qualitative secondary analysis used an interpretive descriptive approach to inductively analyze 30 semi-structured interviews, which included 5 IWDs and their 6 informal caregivers (ICGs). Interviews were conducted over a year at the baseline, 6 months, and 12 months. Five ways of decision-making were identified: (a) independent, (b) collaborative, (c) guided, (d) delegated, and (e) directed. Contrary to IWDs’ preference for independent decision-making, they most often made guided decisions. Guided decision-making was used when IWDs did not recognize their need to make the specified decision, and when the IWD or their ICG perceived that the IWD needed guidance in their decision. Involvement of IWDs in their decision-making was maximized when their decisions were guided.