Interventions to support the decision-making process for older people facing the possibility of long-term residential care
Editorial Group: Cochrane Consumers and Communication Group
Published Online: 18 JUL 2007
Assessed as up-to-date: 28 MAR 2005
Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Gravolin M, Rowell K, de Groot J. Interventions to support the decision-making process for older people facing the possibility of long-term residential care. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD005213. DOI: 10.1002/14651858.CD005213.pub2.
- Publication Status: Edited (no change to conclusions)
- Published Online: 18 JUL 2007
The decision to enter long-term care is often a major life event for older people, made in the context of personal crisis and loss. We hypothesised that the process through which a decision to enter long-term residential care emerges affects the overall psycho-social adjustment to, and acceptance of, this decision, and may have an impact on a range of other outcomes for older persons and their carers, such as health status.
To assess the effects of various decision-support interventions delivered by health or social care providers on the outcomes of older people facing the possibility of entering long-term residential care.
We searched: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1 2005); MEDLINE (Ovid) (1966 to November week 3 2004); PsycINFO (Ovid) (1872 to February week 4 2005); and other databases. There were no language restrictions.
Randomised controlled trials, quasi-randomised controlled trials/quasi-experimental trials, controlled before and after studies, controlled prospective studies and interrupted time series studies of assessment, information provision, counselling, decision-making facilitation, provision of choice, timing of the process, other communication strategies and any other intervention deemed relevant in supporting decision making for older people facing the possibility of long-term residential care.
Data collection and analysis
As there were no studies that met the inclusion criteria no data collection or analysis was conducted.
No studies met the review's inclusion criteria. Although the searches identified a number of studies, they were predominantly opinion pieces or qualitative in nature. While these studies are a potential source of evidence about current practice or people's views, they were not suitable for drawing conclusions about the effects of interventions to support decision-making.
No eligible studies were identified to inform the use of interventions to support the decision-making process for older people facing the possibility of long-term residential care. This should not be interpreted as demonstrating that these interventions are not effective. The many related studies we identified which did not meet the study design criterion for this review indicate that there is substantial research interest in this topic. It would be useful to summarise the information available in the wider literature using newly-developing methods for synthesising qualitative studies. This could help identify interventions which warrant further research. Rigorously conducted randomised controlled trials of these interventions could then make a valuable contribution to the range of evidence surrounding this significant event in the lives of many older people, informing practice and policy development.
Plain language summary
Ways to support older people deciding whether to enter long-term residential care
The decision to enter long-term care is a major life event for older people. It is usually made at a time of crisis and vulnerability, and there is often pressure to make the decision quickly. How the decision is made may affect older people's adjustment to residential care and quality of life, along with those of their carers or family. There are a number of ways that health professionals provide support to older people making this decision. These include a thorough assessment of their needs, provision of adequate information, counselling, providing choices, and the facilitation and timing of the decision-making process.
The review authors could not find any studies that adequately assessed these interventions. This means that there needs to be more studies, not necessarily that the interventions are not helpful.
Older people who were not able to make decisions due to medical conditions were excluded from the review.
對老年人來說，在碰到個人危機或失落的情況下，要決定是否進入長期照護常常是人生的重大生活事件。我們假設這個進入長期照護之決策過程會影響病人整體之精神社會的調適及最後決定的接受度，而且也會對於老年人本身或照護者的其他指標 (如健康狀況) 可能有所影響。
搜尋資料庫: 我們搜尋了Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2005年第1期) 、MEDLINE (Ovid) (從1966年到3 2004年11月第3週) 、 PsycINFO (Ovid) (從1872年到2005年2月第4週) 、和其他資料庫。搜尋時沒有語言限制
雖然沒有符合納入條件的相關介入研究被發現用於支持老年人面臨可能長期居住照護之決策過程，但這不應被解讀為這些相關的介入是無效的。許多相關試驗雖不符合此次文獻回顧研究設計的納入條件，但仍顯示其有潛在的研究價值。如能以新發展的方法用以綜合質性研究，對於作更廣泛的相關研究文獻回顧可能會有所助益。而且可以找出那些介入值得作進一步的研究。之後再進行這些介入的隨機對照試驗，此將對很多老年人有關此一人生重要事件 (註：即老年人面對可能長期居住照護之決策) 、業界實務訊息、及政策發展提供相關的有效證據。
此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。
支持幫助老年人決定是否進入長期居住照護決策的方法。決定進入長期照護是老年人的一個重大生活事件。它通常在危機及 (身體) 脆弱的時候需要做這個決定，而且常有需要快速決定的壓力。如何作決定可能會影響老年人、照護者和家人對於居住照護的適應與生活品質。健康專業人員有許多方式可以提供給老年人作此一決策的支持，這些包含評估需求、提供足夠資訊、諮詢、提供選項、和決策過程的幫助與時程。本回顧研究排除因健康狀況而無法作決策的老年人。雖然本回顧研究作者並沒有找到任何充分評估這些介入的研究，此意味著需要更多研究，然而並不表示此方面的介入是沒有效的。