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Decision making

Support for carers of people with dementia during hospital admission

The aim of this study was to help develop support services for carers of people with dementia on admission to a district general hospital. Qualitative methodology was used in the form of individual semi-structured interviews. These interviews suggest that service developments need to take into account the individual need of each carer. Identified themes included communication, vulnerability of the carers and the need to develop a therapeutic relationship with the carer as well as the person with dementia.

Thu, 07/20/2017 - 15:11

Evaluating the influence of implicit models of mental disorder on processes of shared decision making within community-based multi-disciplinary teams

This paper reports findings from a qualitative study concerning the influence of implicit models of mental disorder on shared decision making within community-based mental health teams. One-hundred participants representing five distinct multi-agency groups: psychiatrists, community psychiatric nurses, approved social workers, patients and informal carers operating within Leicestershire, England were interviewed using a standard case vignette describing a person whose behaviour suggests he may have schizophrenia.

Thu, 07/20/2017 - 15:10

Who should make the decision on the use of GPS for people with dementia?

Objectives: In recent years advanced technologies, such as Global Positioning Systems (GPS), allow for tracking of human spatial activity and provide the ability to intervene to manage that activity. The purpose of this study is to examine the issue of who should decide about the use of electronic tracking using GPS for people with dementia.

Thu, 07/20/2017 - 15:10

Gatekeepers, proxies, advocates? The evolving role of carers under mental health and mental incapacity law reforms

This article explores the potential impact of the mental health and mental incapacity law reforms on carers. The reform proposals anticipate a number of overlapping and at times conflicting roles for carers (including those of gatekeeper, decision-making proxy and advocate), which is suggestive of an ongoing ambivalence toward the caring role at the level of ethics, policy and strategic planning.

Thu, 07/20/2017 - 15:10

A sociological focus on 'expert patients'

The increase of chronic illness as a leading cause of death has given rise to self-care and expert patient initiatives. Caring for chronically ill people places a tremendous economic burden on the health care system, informal carers, the labour market and benefit system (Department of Health 2001, 2004, 2005). Thus, in many countries health policy encourages patients to become ‘experts’ in the self-management of their conditions in the belief that it will help save money and improve health and well-being (Wanless 2002).

Thu, 07/20/2017 - 15:10

Fair access to care services (FACS) 2010 training module

This e-learning training module aims to support re-orientation and re-skilling of staff directly involved in decision-making using Fair access to care services (FACS) and eligibility criteria, their supervisors and line managers, and those monitoring and reporting on the operations of the system.

Thu, 07/20/2017 - 15:10

Decisions, decisions

The Mental Capacity Act comes into full effect on 1 October 2007. This article aims to provide answers to some of the most frequent voiced questions and misapprehensions from mental health service users, carers, and practitioners about what the Act will mean to them.

Thu, 07/20/2017 - 15:10

A synthesis of knowledge about caregiver decision making finds gaps in support for those who care for aging loved ones

We conducted a mixed-methods knowledge synthesis to assess the effectiveness of interventions to improve caregivers' involvement in decision making with seniors, and to describe caregivers' experiences of decision making in the absence of interventions. We analyzed forty-nine qualitative, fourteen quantitative, and three mixed-methods studies. The qualitative studies indicated that caregivers had unmet needs for information, discussions of values and needs, and decision support, which led to negative sentiments after decision making.

Thu, 07/20/2017 - 15:10

End of life treatment decisions in people with dementia: carers' views and the factors which influence them

Objective. Treatment decisions in life threatening situations (TD) are poorly studied in people with dementia.

Method. The carers of people with dementia were asked four TD questions, pertaining to cardiac resuscitation, intravenous fluids, oral antibiotics and intravenous antibiotics. The impact of key variables (age, dementia severity, psychiatric co-morbidity, physical illness, family relationship of carer) on TD were evaluated.

Thu, 07/20/2017 - 15:10

Extending direct payments to informal carers: some issues for local authorities

The Carers and Disabled Children Act (2000) has the potential to fundamentally change carers services and the way they are currently delivered. As yet, there is little published work that considers the implications of this Act either for local authorities or informal carers themselves. This paper examines the practical issues involved in the implementation of the Act in terms of: providing equitable services, defining terms, young carers and care package limits, local authority eligibility criteria and whether funding is adequate.

Thu, 07/20/2017 - 15:10