IPSDM - DOLCE
Full title of the project
Improving decision making on location of care with the frail elderly and their caregivers
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.
- Impact of home care versus alternative locations of care on elder health outcomes: an overview of systematic reviews.Boland L, Légaré F, Perez MM, Menear M, Garvelink MM, McIsaac DI, Painchaud Guérard G, Emond J, Brière N, Stacey D. BMC Geriatr. 2017 Jan 14;17(1):20.
- Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design.Garvelink MM, Emond J, Menear M, Brière N, Freitas A, Boland L, Perez MMB, Blair L, Stacey D, Légaré F. Res Involv Engagem. 2016 Jul 19;2:26.
- Giving voice to older adults living with frailty and their family caregivers: engagement of older adults living with frailty in research, health care decision making, and in health policy.Holroyd-Leduc J, Resin J, Ashley L, Barwich D, Elliott J, Huras P, Légaré F, Mahoney M, Maybee A, McNeil H, Pullman D, Sawatzky R, Stolee P, Muscedere J. Res Involv Engagem. 2016 Jun 17;2:23.
- A Synthesis Of Knowledge About Caregiver Decision Making Finds Gaps In Support For Those Who Care For Aging Loved Ones.Garvelink MM, Ngangue PA, Adekpedjou R, Diouf NT, Goh L, Blair L, Légaré F. Health Aff (Millwood). 2016 Apr;35(4):619-26.
- In for a penny, in for a pound: the effect of pre-engaging healthcare organizations on their subsequent participation in trials. Garvelink MM, Freitas A, Menear M, Brière N, Stacey D, Légaré F. BMC Res Notes. 2015 Dec 8;8:751.
- Improving Decision making On Location of Care with the frail Elderly and their caregivers (the DOLCE study): study protocol for a cluster randomized controlled trial.Légaré F, Brière N, Stacey D, Bourassa H, Desroches S, Dumont S, Fraser K, Freitas A, Rivest LP, Roy L. Trials. 2015 Feb 12;16:50.
- An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team. Légaré F, Stacey D, Brière N, Robitaille H, Lord MC, Desroches S, Drolet R. BMC Geriatrics. 2014 Jul 2; 14:83.
- A systematic process for creating and appraising clinical vignettes to illustrate interprofessional shared decision making. Stacey D, Brière N, Robitaille H, Fraser K, Desroches S, Légaré F. J Interprof Care. 2014 Apr 28.
- Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: A mixed methods study. Légaré F, Stacey D, Briere N, Fraser K, Desroches S, Dumont S, Sales A, Puma C, Aubé D. J Interprof Care. 2013 Feb 8
- Interprofessionalism and shared decision making in primary care: a stepwise approach towards a new model. Légaré F, Stacey D, Pouliot S, Gauvin FP, Desroches S, Kryworuchko J, Dunn S, Elwyn G, Frosch D, Gagnon MP, Pluye P, Graham ID. J Interprof Care. 2011 Jan;25(1):18-25.
- Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study. Légaré F, Stacey D, Gagnon, S, Dunn S, Pluye P, Frosch D, Kryworuchko J, Elwyn G, Gagnon MP, Graham ID. J Eval Clin Pract. 2011 Aug;17(4):554-64.
- Interprofessional education for interprofessional practice about patients' decision support/patients' decision aids.Llewellyn-Thomas HA, Légaré F. J Interprof Care. 2011 Nov;25(6):399-400.
- A conceptual framework for interprofessional shared decision making in home care: protocol for a feasibility study. Légaré F, Stacey D, Brière N, Desroches S, Dumont S, Fraser K, Murray MA, Sales A, Aubé D. BMC health Serv Res. 2011 Jan 31; 11:23.
- Shared decision making models to inform an interprofessional perspective on decision making: a theory analysis. Stacey D, Légaré F, Pouliot S, Kryworuchko J, Dunn S. Patient education and counseling. 2010 Aug;80(2):164-72.
- Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol. Légaré F, Stacey D, Graham ID, Elwyn G, Pluye P, Gagnon MP, Frosch D, Harrison MB, Kryworuchko J, Pouliot S, Desroches S. BMC Health Services Research 2008, 8:2.