IPSDM - DOLCE

Full  title of the project

Improving decision making on location of care with the frail elderly and their caregivers

Project description 

One of the toughest decisions faced by the frail elderly in Canada is whether to stay at home or move to a care facility. It is certainly difficult to make this decision alone, but can be even harder if someone else makes it for you. Shared decision making is when, instead of making decisions for the patient, healthcare professionals share information about what the evidence says, and they talk about what's important with the patient, and then make the decision together. In the case of the frail elderly in home care services, there are many health care professionals involved, e.g. the doctor, nurse and social worker. In this case decisions should be shared by all the professionals involved with the elderly person along with his or her caregivers. Unfortunately, in this context, shared decision making rarely occurs. We have designed a training program that teaches interprofessional teams how to share decisions with their frail elderly patients, and tested it in one Quebec City and one Edmonton home care team. This project tested the training program on a broader scale with 16 home care teams attached to community health centres across the province of Quebec, and compared the results with what happens when no one has completed the training (usual care). Results show that caregivers followed by the trained home care teams felt more involved in the decision making process, and that there was a better fit with the prefered choice and the choice made. 

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Publications

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