Shared decision-making with adults transitioning to long-term care: A scoping review.
Caroline Egan, Corina Naughton, Maria Caples and 1 others
PMID 36480119WHAT IT FOUND
Older adults often felt excluded from decisions about moving to long-term care, while caregivers struggled when resources, options, or declining cognition made shared choices difficult.
Key findings
01Older adults often felt excluded from decisions about moving to long-term care, while family caregivers sometimes made decisions they knew the person disagreed with.
02Proactive planning, offering real choices such as staying at home or relocating, and collaboration among older adults, family caregivers and professionals were identified as facilitators.
03Barriers included declining cognitive capability, limited resources, lack of options, and concerns that web-based aids may exclude adults who are not comfortable with technology.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review excluded grey literature because of time and resources. It included protocols and evidence from a recent field, so effectiveness is not established. Much evidence came from Canadian home care and may not transfer to other systems. Older adults' own experiences were not available from the Canadian trials at the time of review. Sampling lacked diversity and longitudinal data were absent. Web-based tools may exclude adults not comfortable with technology.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that shared decision-making interventions improve outcomes for adults moving to long-term care. It is a scoping review, and the included studies are heterogeneous, often protocol or caregiver-focused, with limited older adult data.