Dementia Clinical Trial
Official title:
SHARED DECISION MAKING ON A 'LIFE-AND-CARE PLAN' IN LONG-TERM CARE FACILITIES
Shared Decision Making (SDM) is defined as a process where healthcare professionals and
patients make decisions together, using the best available evidence. SDM, as a communication
and decision method, can be used also with persons suffering from dementia. Yet, SDM with
persons with dementia or even with their family caregivers is not widespread.
The present research project aims to develop and evaluate an SDM framework in care planning
to be implemented in long-term care facilities, in order to obtain a constantly developing
care plan that focuses not only on the medical, physical, psychosocial and spiritual needs
of the resident, but that considers and documents his preferences and the actions taken by
caregivers to meet them.
The current project is a controlled exploratory study. Case studies that involve a triad in
each case, composed by the resident with moderate or severe dementia, his family caregiver
and the professional usually taking care for the resident, will be used (n=16 professionals;
n=40 residents; n=40 family caregivers). Professional caregivers of two nursing homes, one
located in Italy and one in the Netherlands, will receive a specific training in SDM
principles and will guide the SDM interview within the triad. Primary outcome will be the
proportion of residents whose preferences and needs, together with the related actions to
meet them, are known, documented and satisfied in their 'life-and-care plans'. Secondary
outcomes are the residents' and family caregivers' quality of life; the family caregivers'
sense of competence and the healthcare professionals' job satisfaction. Semi-structured
interviews and focus group interviews will be performed to assess satisfaction with the
intervention and barriers and facilitators to its implementation. Assessments are performed
at baseline and six months after the intervention.
We hypothesize that the use of the SDM process in care planning will increase the number of
met needs and will improve the residents' and family caregivers quality of life, the family
caregivers' sense of competence and the healthcare professionals' job satisfaction.
The key element of this study is that it will contribute to our knowledge about the efficacy
and feasibility of an SDM framework in care planning in long-term care facilities with
persons with moderate to severe dementia.
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