Person-centered care for people with aphasia: tools for shared decision-making.
Jacqueline Hinckley, Mark Jayes
PMID 37928752WHAT IT FOUND
Aphasia does not automatically prevent shared decision-making.
Supported conversation, written key words, yes/no choices, and co-created communication plans can help people with aphasia express preferences. Training and ongoing team support are needed.
Key findings
01Aphasia does not automatically remove decision-making ability, but some practitioners wrongly assume people with aphasia cannot decide for themselves.
02Supported conversation training and communication plans need hands-on practice with people with aphasia and feedback, not just tool instruction.
03Most decision aids and capacity tools were not designed for aphasia, so they may not be accessible.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not a new trial or systematic review, so it does not show how much any tool improves patient outcomes. Many cited tools were not designed for aphasia, and the paper says more research is needed to develop and evaluate capacity assessment tools for communication disabilities. The recommended tools require staff training, ongoing support, time, and organizational follow-through, so they may be hard to adopt in busy services. Success depends on adapting each person's communication supports and respecting whether they want to lead or defer decisions, so no single approach fits everyone. Capacity law and tools vary by jurisdiction, so local legal guidance is needed before applying the assessment recommendations.
The easy way to misread this
Do not read this as proof that a communication plan or supported conversation training by itself improves clinical outcomes. It is a narrative review of tools, and the paper says many aids were not designed for aphasia and that success depends on training, ongoing support, and adaptation.