Making care decisions in home-based dementia care: why context matters
Open accessAbstract
RÉSUMÉ D’ici à 2038, le nombre d’heures de soins non rémunérées aux aînés offert par les membres de la famille devraient tripler. Les membres des familles sont souvent suppliés d’aider dans le processus parce que vivre avec la démence peut inhiber la capacité pour prendre une décision. Cette étude ethnographique a soumis les relations au sein de soins de la démence à domicile à un examen critique par le biais des entrevues face-à-face et les observations des participants des clients, des aidants naturels et des prestataires de soins à domicile. Les résultats ont révélé comment les décisions sont imposées dans le contexte du système de soins à domicile formels, et ont mis en évidence trois thèmes: (1) L’accommodation de la compétence/incompétence, comme définie cliniquement; (2) La prise de décisions inopportunes; et (3) Le renforcement de l’exclusion des déments dans la prise de décision. Ces thèmes illuminent la façon dont les valeurs culturelles (la compétence), les croyances (l’immuabilité du système) et les pratiques (le réglage des décisions) dans le système de soins à domicile sont finalement déterministes dans la prise de décisions pour les déments et leurs aidants. Afin d’optimiser la santé des déments qui se font soignés à domicile, il faut accorder d’attention supplémentaire aux pratiques collaboratives et inclusives des membres des familles.
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Home care case managers tend to pay more attention to the lack of available resources or system pressures when making care decisions, while family caregivers consider the relational effects that decisions would have on the family unit.
“For example, home care case managers tend to pay more attention to the lack of available resources or system pressures when making care decisions while family caregivers consider the relational effects that decisions would have on the family unit [50].”
From Towards defining quality in home care for persons living with dementia (2022) · cites this paper as [50]
The tension between what is considered essential and valued in quality home care, such as personalized and flexible care, is at odds with constraints imposed by the existing home care system.
“The tension between what is considered essential and valued in quality home care, like personalized and flexible care, is at odds with constraints imposed by the existing home care system [49,50].”
From Towards defining quality in home care for persons living with dementia (2022) · cites this paper as [50]
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- Authors
- St-Amant, O., Ward-Griffin, C., DeForge, R. T., Oudshoorn, A., McWilliam, C., Forbes, D., Kloseck, M., & Hall, J.
- Affiliations
- Western University (CA)
- University of Alberta (CA)
- Corresponding author
- St-Amant, Oona
- Venue
- Canadian Journal on Aging / La Revue canadienne du vieillissement
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-12
- Volume
- 31
- Issue
- 4
- Pages
- 423-434
- ISSN
- 0714-9808 (ISSN-L)
- 1710-1107
- OpenAlex
- W2158012184
- Cited by
- 44
- References
- 59
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 1 · 2012: 1
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Canadian Journal on Aging / La Revue canadienne du vieillissement (publishedVersion)
- PubMed (publishedVersion)
- Project Muse (Johns Hopkins University) (submittedVersion)
- Scholarship@Western (Western University) (submittedVersion)
- ERA: Education and Research Archive (University of Alberta)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- dementia care, home care, care decision-making, family caregivers, natural caregivers, competency assessment, caregiver-family relationship
- MeSH terms
- Aged, Aged, 80 and over, Decision Making, Dementia, Female, Home Nursing, Humans, Male
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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