The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature

Abstract Background: As care homes play an important role in the lives of an increasing number of older people, it is pivotal to understand how residents’ and their families engage in decision-making about their care and support. Internationally, there is an increasing emphasis in long-term care set...

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Main Authors: Brighide Lynch, Assumpta A. Ryan, Marie O’Neill, Sarah Penney
Format: Article
Language:English
Published: BMC 2022-11-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-022-03503-8
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author Brighide Lynch
Assumpta A. Ryan
Marie O’Neill
Sarah Penney
author_facet Brighide Lynch
Assumpta A. Ryan
Marie O’Neill
Sarah Penney
author_sort Brighide Lynch
collection DOAJ
description Abstract Background: As care homes play an important role in the lives of an increasing number of older people, it is pivotal to understand how residents’ and their families engage in decision-making about their care and support. Internationally, there is an increasing emphasis in long-term care settings on the right of residents to be actively involved in all aspects of decision-making about their care and support. However, the steps necessary to achieving a culture of shared decision-making in long-term care settings remain unclear. The aim of this literature review is to summarise what is known in the literature about the factors that influence care home residents’ and families’ engagement with decision-making about their care and support. Methods: An integrative literature reviews was carried out, guided by the methodological framework proposed by Whittemore and Knafl (2005). CINAHL, Medline Ovid and ProQuest Health and Medical databases were searched for relevant articles from 2011 to 2021. A three-step method was used, including the use of reference and citation management software to manage search results and identify duplicate citations. Abstracts and full texts were reviewed by two reviewers. Details of the selected articles were then extracted using the Data Extraction Form. Results: In total, 913 articles were located and 22 studies were included in the final analysis. The thematic analysis identified three main themes that illustrate the complexities of shared decision-making in care homes: (a) a positive culture of collaborative and reciprocal relationships; (b) a willingness to engage and a willingness to become engaged; and (c) communicating with intent to share and support rather than inform and direct. Conclusion: The implementation of shared decision-making in care homes is highly dependent on the support and nurturing of collaborative and reciprocal relationships between residents, families, and staff. Part of this process includes ascertaining the willingness of residents and families to become engaged in shared decision-making. Communication skills training for staff and guided approaches that view decision-making as a supportive process rather than a once off event are essential prerequisites for implementation.
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spelling doaj.art-9e06c2d4997a45c9b0585244569b5ba52022-12-22T03:43:26ZengBMCBMC Geriatrics1471-23182022-11-0122111710.1186/s12877-022-03503-8The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literatureBrighide Lynch0Assumpta A. Ryan1Marie O’Neill2Sarah Penney3School of Nursing and Institute of Nursing and Health Research, Ulster UniversitySchool of Nursing and Institute of Nursing and Health Research, Ulster UniversitySchool of Nursing and Institute of Nursing and Health Research, Ulster UniversitySchool of Nursing and Institute of Nursing and Health Research, Ulster UniversityAbstract Background: As care homes play an important role in the lives of an increasing number of older people, it is pivotal to understand how residents’ and their families engage in decision-making about their care and support. Internationally, there is an increasing emphasis in long-term care settings on the right of residents to be actively involved in all aspects of decision-making about their care and support. However, the steps necessary to achieving a culture of shared decision-making in long-term care settings remain unclear. The aim of this literature review is to summarise what is known in the literature about the factors that influence care home residents’ and families’ engagement with decision-making about their care and support. Methods: An integrative literature reviews was carried out, guided by the methodological framework proposed by Whittemore and Knafl (2005). CINAHL, Medline Ovid and ProQuest Health and Medical databases were searched for relevant articles from 2011 to 2021. A three-step method was used, including the use of reference and citation management software to manage search results and identify duplicate citations. Abstracts and full texts were reviewed by two reviewers. Details of the selected articles were then extracted using the Data Extraction Form. Results: In total, 913 articles were located and 22 studies were included in the final analysis. The thematic analysis identified three main themes that illustrate the complexities of shared decision-making in care homes: (a) a positive culture of collaborative and reciprocal relationships; (b) a willingness to engage and a willingness to become engaged; and (c) communicating with intent to share and support rather than inform and direct. Conclusion: The implementation of shared decision-making in care homes is highly dependent on the support and nurturing of collaborative and reciprocal relationships between residents, families, and staff. Part of this process includes ascertaining the willingness of residents and families to become engaged in shared decision-making. Communication skills training for staff and guided approaches that view decision-making as a supportive process rather than a once off event are essential prerequisites for implementation.https://doi.org/10.1186/s12877-022-03503-8Care homeResidentFamiliesShared decision-makingEngagementCare
spellingShingle Brighide Lynch
Assumpta A. Ryan
Marie O’Neill
Sarah Penney
The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature
BMC Geriatrics
Care home
Resident
Families
Shared decision-making
Engagement
Care
title The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature
title_full The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature
title_fullStr The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature
title_full_unstemmed The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature
title_short The factors that influence care home residents’ and families’ engagement with decision-making about their care and support: an integrative review of the literature
title_sort factors that influence care home residents and families engagement with decision making about their care and support an integrative review of the literature
topic Care home
Resident
Families
Shared decision-making
Engagement
Care
url https://doi.org/10.1186/s12877-022-03503-8
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