Call for decision aids specific to residential aged care

There is a gap in how health professionals collaborate with aged care residents and families about treatment options, says a researcher investigating shared decision making in Australian residential aged care.

There is a gap in how health professionals collaborate with aged care residents and families about treatment options, says a researcher investigating shared decision making in Australian residential aged care.

Kaye Ervin is using her years of experience as an aged care nurse working in many roles including enrolled nurse, registered nurse, project manager, nurse practitioner candidate and nurse unit manager to shed new light on shared decision making (SDM) in residential aged care.

Shared decision making incorporates high-quality evidence of the risks and benefits, which is missing in most decision making processes with residents or their proxy decision makers, she said.

“There is a distinct gap in how nurses and clinicians in general collaborate with residents and families about treatment options,” Ms Ervin told Australian Ageing Agenda.

“There are moral, ethical and legal concerns about consent processes used in treatment options, especially when treatment carries considerable risks,” she said.

As part of her PhD at LaTrobe University, she has published several articles relating to the background of the study, including the conceptual basis of shared decision making to help clinicians understand it more fully.

“Despite policy and regulations in Australian aged care facilities that promote resident choice and autonomy, there are many barriers to true partnerships with residents and their families” Ms Ervin said.

“Shared decision making has been shown to promote true collaboration between clinicians and care recipients, yet the uptake of this model in Australia has been very minimal in any healthcare setting.”

Shared decision making researchers Helen Haines and Kaye Ervin

SDM barriers and enablers

Ms Ervin has reviewed the literature for models of shared decision making in residential aged care to identify potential barriers and enablers.

“A culture of person-centred care is essential for residential aged care facilities to implement SDM,” she said.

“A major barrier to the uptake of SDM in residential aged care, or any healthcare setting, is the ability of staff to access high-quality evidence of the risks and benefits of treatments and effectively communicate this to residents and their proxy decision makers,” Ms Ervin said.

People make decisions daily based on what they know or previous experience, she said.

“Healthcare is complex and many people have little experience or knowledge of their treatment options or the risks regarding the treatment.

“It is our job as nurses to provide people with the information; not make the decisions for them based on our knowledge,” she said.

Ms Ervin said that tools such as patient decision aids offered hope in implementing shared decision making in residential aged care, but decision aids did not exist for all treatment options.

“There is a need to develop patient decision aids specific to aged care settings and to research implementation of shared decision making in this setting to determine how best to introduce it.”

The next phase of Ms Ervin’s PhD study is to develop a patient decision aid for antipsychotic use in dementia care and introduce it to residential aged care facilities via a controlled trial.

Her current research Shared Decision Making in Residential Aged Care: A Framework Synthesis, which was co-authored with Helen Haines and Irene Blackberry, has recently been published in the Open Journal of Nursing and is available here.

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Tags: decision-aids, kaye-ervin, latrobe-university, shared-decision-making,

1 thought on “Call for decision aids specific to residential aged care

  1. Hmmm – there is just the small matter of the law on decision making to include in this worthy research

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