Decision-Making Involvement Preferences of Older Adults

Overview

Status: Not yet recruiting
Keywords: treatment decision-making , geriatrics
IRB Number: 00055443
Specialty: Geriatrics
Sub Specialties:

Brief Summary

Purpose:

The purpose of this study is to generate a description the health care decision-making practices and preferences of older adults across a range of cognitive function, and to identify characteristics of individuals and their decision-making companions (when present) that affect satisfaction with medical decisions.  This data will be used to develop a model of inclusive decision making for older adults with diminished decisional capacity that will support the development of interventions and clinical best practices to promote the inclusion of individuals with diminished capacity in their own medical decisions.

Specific Aim 1

Describe health care decision making patterns and preferences among older adults representing a range of cognitive function from the perspective of the older adult.  

Aim 1.1:  Describe the level of control that older adults report that they exercise during recent health care encounters as measured by the modified Control Preference Scale (CPS).

Aim 1.2:  Describe the level of control that older adults want to exercise during health care encounters as measured by the modified CPS.

Aim 1.3:  Describe the balance of authority older adults want between their decision companions and physicians in the event they are unconscious, as measured by the modified CPS.

Aim 1.4:  Describe other domains of the adults’ decision-making preferences that may not be measured by the CPS.

Aim 1.5:  Describe relationships between demographic variables and decision-making preferences of older adults.

Specific Aim 2

Describe health care decision making patterns and preferences among individual adults as reported by a decision-making companion.    

Aim 2.1:  Describe the level of control the companion reports that the older adult exercised during medical encounters as measured by the modified CPS.

Aim 2.2:  Describe the level of control the companion predicts the older adult would have preferred to exercise during medical encounters as measured by the modified CPS.

Aim 2.3:  Describe the companion’s control preference when making his/her own treatment decisions, as measured by the CPS.

Aim 2.4:  Describe relationships between older adults’ preferences and companions’ assessments of older adults’ preferences and companions’ personal preferences.

Specific Aim 3

Aim 3.1: Describe older adults’ satisfaction with the decision-making process as measured by the Satisfaction with Decision Scale (SDS).  

Aim 3.2: Describe relationships between older adults’ satisfaction with the decision-making process as measured by the SDS and (1) concordance between the actual decision-making process and the ideal decision-making process, (2) concordance between the older adults’ ideal preferences and the decision-companions’ preferences, (3) concordance between the older adults’ preferences and the decision companions’ view of the older adults’ preferences. 

Aim 3.3:  Describe relationships between demographic variables and older adults’ satisfaction with decisions.

Principal Investigator: Maureen Henry
Department: College of Nursing
Co Investigator:

Contact Information

Name:Maureen Henry
Phone: 801-673-1048
Email: maureen.henry@utah.edu

Inclusion Criteria

Inclusion Criteria

Patient Participants

Companion Participants

Age 65 and older

Referred to study as a companion by the patient participant

  

No fewer than 20 participants with known cognitive impairment will be enrolled.

Willing to allow data to be extracted from medical records

 

Exclusion Criteria

Exclusion Criteria

Non-English speaking

Psychiatric or physical illness that would interfere with completion of assessments and interviews

Vision and hearing that is inadequate to respond to questionnaires and interviews

Inadequate cognitive capacity to complete assessments and interviews