Decision-Making Support for People Living With Dementia: A Nationwide Cross-Sectional Study in Diverse Long-Term Care Settings in Japan
Corresponding Author
Ayane Komatsu
Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka, Japan
Correspondence:
Ayane Komatsu ([email protected])
Search for more papers by this authorTami Saito
Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorYoshihisa Hirakawa
Department of Health Research and Innovation, Aichi Comprehensive Health Science Center, Aichi, Japan
Search for more papers by this authorSanae Takanashi
Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorReiko Ishiyama
Development of Care and Network, International University of Health and Welfare Graduate School, Tokyo, Japan
Search for more papers by this authorKaoruko Aita
Graduate School of Humanities and Sociology, The University of Tokyo, Tokyo, Japan
Search for more papers by this authorHisayuki Miura
Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan
Clinical Research Center, Yushoukai Medical Corporation, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Ayane Komatsu
Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka, Japan
Correspondence:
Ayane Komatsu ([email protected])
Search for more papers by this authorTami Saito
Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorYoshihisa Hirakawa
Department of Health Research and Innovation, Aichi Comprehensive Health Science Center, Aichi, Japan
Search for more papers by this authorSanae Takanashi
Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan
Search for more papers by this authorReiko Ishiyama
Development of Care and Network, International University of Health and Welfare Graduate School, Tokyo, Japan
Search for more papers by this authorKaoruko Aita
Graduate School of Humanities and Sociology, The University of Tokyo, Tokyo, Japan
Search for more papers by this authorHisayuki Miura
Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan
Clinical Research Center, Yushoukai Medical Corporation, Tokyo, Japan
Search for more papers by this authorFunding: This work was supported by the Ministry of Health, Labor and Welfare (MHLW) Health and Labor Sciences Research Grants [grant number 21GB1001], and the Japan Society for the Promotion of Science (JSPS) KAKENHI [grant number 21K13473].
ABSTRACT
Background
The importance of decision-making support for people living with dementia (PLWD) has been pointed out, but the actual situation has not been fully clarified. This study aimed to describe the implementation of decision-making support for PLWD in three long-term care settings in Japan: hospitals, facilities, and homes.
Methods
A questionnaire survey was conducted among 1000 randomly selected long-term care wards in hospitals (LTCHs), geriatric health service facilities (GHSFs), and home care nursing services (HNSs) between November 2022 and January 2023. Responses were collected using the 15-item decision-making support originally developed. In addition to calculating the implementation rate, the bivariate association between decision-making support implementation and facility characteristics was examined for items with low implementation rates. All analyses were conducted based on the facility type.
Results
The study received 97 (9.7%), 164 (16.4%), and 215 (21.5%) valid responses from LTCHs, GHSFs, and HNSs, respectively. Across all care settings, ‘confirm key family's wishes’ was the most implemented aspect. In contrast, over half of the facilities did not implement ‘support conducting a life review’ and ‘support expression and execution of wishes’ in LTCHs and GHSFs. The implementation rate of these items was higher among facilities providing training on decision-making support and advanced care planning training for staff members.
Conclusions
In all care settings, prioritizing family wishes occurred without assessing the decision-making capacity of PLWD. Training in decision-making support and advanced care planning showed potential for encouraging the implementation of decision-making support for PLWD. However, further investigation is necessary.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data supporting the findings of this study are not publicly available because of privacy or ethical restrictions.
Supporting Information
| Filename | Description |
|---|---|
| psyg70059-sup-0001-Supinfo.docxWord 2007 document , 289.3 KB |
Figure S1. Flow chart of participant inclusion criteria. Table S1. Items of decision-making support. Table S2. Characteristics of decision-making support by place of care. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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