Family caregivers’ involvement in decision-making processes regarding admission of persons with dementia to nursing homes
Open accessAbstract
The current Western health policy of ageing in place relies on a triad collaboration among patients, healthcare service providers and family caregivers. Such collaborations presuppose involvement in a vague juridical landscape. This article explores family caregivers’ experiences with involvement in and influence on nursing home decision-making processes for persons with dementia. The data consist of 12 in-depth interviews with family caregivers. Using positioning theory, we demonstrate how family caregivers strive to balance their assumed duty to care for the person with their needs to care for themselves. Their involvement (or non-involvement) in the complex decision-making process is demonstrated through the following seven positions: (1) self-condemning determiner, (2) dominant, (3) proponent, (4) saluting, (5) pending, (6) prisoner, and (7) stooge. Furthermore, we discuss why expedient positions are more available for some individuals and the consequences of family caregivers’ various positions on the healthcare policy aims of collaboration and equal healthcare services.
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Caregivers often experienced conflicts between systemic pressures and the care needs of their loved ones, with some expressing concerns that local health care services excessively relied on them to continue caring, leading to feelings of exploitation.
“Caregivers often experienced conflicts between systemic pressures (e.g., lack of funding for services) and the care needs of their loved ones, with some caregivers expressing concerns that local health care services excessively relied on them to continue caring, leading to feelings of exploitation (Ashbourne et al., 2021; Larsen et al., 2020).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Larsen et al., 2020
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Greene, L., Brain, J., Watkins, P., Kafadar, A. H., Sabatini, S., Blundell, B., Bothe, E., Harper, K., Hersh, D., Morrisby, C., et al. (2026) · The Gerontologist · doi:10.1093/geront/gnaf275 · Cited by 9 · see citing works
- Authors
- Larsen, L. S., Blix, B. H., & Hamran, T.
- Affiliations
- UiT The Arctic University of Norway (NO)
- Corresponding author
- Larsen, Lill Sverresdatter
- Venue
- Dementia
- Publisher
- SAGE Publications
- Published
- 2018-11-23
- Volume
- 19
- Issue
- 6
- Pages
- 2038-2055
- ISSN
- 1471-3012 (ISSN-L)
- 1741-2684
- OpenAlex
- W2900493510
- Semantic Scholar
- 51016752c9a680ea5316418282c0f284e648afe7
- Cited by
- 26
- References
- 35
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 11 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 1
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Dementia (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- family caregivers, nursing home admission, decision-making, caregiver involvement, aging in place, positioning theory, caregiver self-care, collaborative care
- MeSH terms
- Aged, Decision Making, Dementia, Family, Humans, Nursing Homes, Patient Admission, Caregivers, Independent Living
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