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Involvement of hospitalized persons with dementia in everyday decisions : A dyadic study
Miller, Lyndsey M. Lee, Christopher S. Whitlatch, Carol J. Lyons, Karen S.
Miller, Lyndsey M.
Lee, Christopher S.
Whitlatch, Carol J.
Lyons, Karen S.
Abstract
Background and Objectives
To examine the involvement of persons with dementia (PWDs) in everyday decision making from the perspectives of hospitalized PWDs and their family caregivers, and to identify determinants thereof.
Research Design and Methods
Using multilevel modeling, we examined cross-sectional data collected prospectively from 42 family care dyads regarding the care values of the PWD.
Results
Both members of the dyad rated the PWD, on average, as being “somewhat involved”. There was a significant amount of variability around the average perceptions of PWD involvement in decision making for both PWDs (χ2 = 351.02, p < .001) and family caregivers (χ2 = 327.01, p < .001). Both PWDs and family caregivers were significantly more likely to perceive greater PWD involvement in decision making when the family caregiver reported the PWD as valuing autonomy. Additionally, PWDs were significantly more likely to report greater involvement when they had greater cognitive function. Finally, family caregivers perceived significantly greater involvement of the patient in decision making when they reported less strain in the relationship. Together, autonomy, relationship strain, cognitive function, and care-related strain accounted for 38% and 46% of the variability in PWDs’ and family caregivers’ perceptions, respectively, of the PWD’s decision-making involvement.
Discussion and Implications
Although research indicates that decision-making abilities decline with advancing dementia, these results imply that working with families to support PWDs in their value of autonomy and mitigate strain in the dyad’s relationship may help prolong PWDs’ decision-making involvement.
Keywords
interpersonal context, informal caregiving, multilevel modeling, patient autonomy
Date
2018
Type
Journal article
Journal
Gerontologist
Book
Volume
58
Issue
4
Page Range
644-653
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled