Informed decision making for elderly

Abstract

The extended longevity in the past decades requires both professionals and families to make decisions on health and social care arrangements increasingly. From time to time, professionals including medical doctors, nurses, and social workers are expected to engage families in decision making processes by identifying needs, exploring options, and informing them health and social care options, advantages and disadvantages of each option, and potential impacts. While health belief model is widely adopted in healthcare decision-making, review of literature revealed three challenges when applying this model in informed decision making for elderly. First, the underlying assumption of the desire to avoid illness or getting well is challenged by the observation that some older adults are living with chronic conditions such as cognitive impairment. Second, experiences of families with older adults suffer from end-stage conditions question that certain actions will prevent or lessen the changes of illness. Third, literature and field observations among Chinese older adults showed a tendency of relying on children and medical doctors in the decision-making process. A cultural-sensitive model of informed decision making for elderly is urgently in need.