Health Care Essay Whether A Person With Dementia Should Involve In Their Healthcare Decision
Question
Task: Write a health care essay on the topic “Should a person living with dementia be involved in decision making regarding their healthcare?” using relevant literature.
Answer
Introduction
The current health care essay talks about the “Dementia” which is a neurocognitive disorder that creates a deficit in the cognitive ability of the person. As the cognitive problem rises the decision, making process becomes highly difficult for the people. However, there are evidence that even with dementia and other advanced diseases, people can articulate their values, preferences and choices effectively and logically. Thus, there is a going debate on the involvement of people facing dementia in decision-making process for their healthcare (Barker, Lynch & Hopkinson, 2017). There are rising desire among the people facing dementia to take part in the decision making process because the healthcare decision with directly impact their lives. Thus, the health care essay critically analyzes past works of literature to examine the works of scholars in this study area and their findings on whether people suffering dementia should be involved in their own healthcare decision.
Discussion
According to Barker, Lynch & Hopkinson (2017) there are increasing number of people that are suffering from dementia and there are rising expectation that the health decisions is made in collaboration with the patient and the family as the person enters the end stage of dementia. The article aimed at reviewing the evidence on the support needs from informal carers of patients suffering end-stage dementia. The findings of the paper stated that while forming a health plan for a dementia patient it is important to consider both the person and their carers in the decision. This is important for supporting people facing dementia problem and make them feel important, and reduces the risk of the carer in taking decision for an end stage dementia patient. The article was successful in stating that dementia patient should be included in decision-making process for their carer. The finding was highly reliable because it made use of wide range of papers from past sixteen years. However, the paper had limitations in using primary resources or responses on the study and this reduces the accuracy of the result for dementia decision-making process.
Herein health care essay, Mriani et al., (2017) further aimed at finding the shared decision making process in dementia healthcare where the people with dementia can make their own care planning in long-term. The findings of the article states that it is appropriate to include the people with dementia in long-term care plan because it will help in personalization of their planning for care. This shows that the findings of the article has effectively answered the research topic that persons with dementia should be present during their healthcare decision because it will affirm value of their existence and allow health professionals to give respect and support. However, the article involved participants regardless of level of cognitive ability and this fails to confirm that intervention of late stage dementia people in decision making is appropriate.
Daly, Bunn & Goodman (2018) also points out on the efficiency of the shared decision making process for people facing dementia, however, this is done in an extended care setting environment. the findings of the article states that shared decision making among cognitive challenged people help in improving life both the patient as well as the support carer. This shows the importance of shared decision making in care facility of dementia patient and answers the topics effectively that involvement of patient is beneficial. However, the article lacked in stating the resources that support shared decision making in care setting and the way these opportunities are created for shared decision-making. This limits the ability of the article to accurately state whether patients facing dementia should be included in care decision making.
Additionally it is seen in this health care essay that Smebye, Kirkevold&Engedal (2012) has aimed in the article to examine the way in which the patient facing dementia can participate in making decision for their health care. The findings of the article shows that persons facing moderate dementia should be considered as capable of influencing decisions and the caregivers should consider the experience of the patients to form care decisions. However, there are variability in the ways the people facing dementia participate in decision process. Thus, it has effectively answers the research question by effectively supporting the participation of dementia patients in their care decision. However, there are gaps in findings that fails to answer the topic effectively because it not consider the participation of people with sever dementia in the decision process.
The article by Fetherstonhaugh, Tarzia& Nay (2013) aimed at analyzing the essence of decision making for the patients suffering from dementia. The findings of the article shows that involving people with dementia problem in health decision making is difficult even though moderate dementia patient has the ability to participate. This is because of the attitudinal barriers from the care givers and the family that make involvement of dementia patient difficult. This adds valuable information to the topic showing that involvement of dementia patients in decision-making is difficult and suffers barriers. However, the findings also show that patients with dementia should be kept in the central of the care decision because it is a way to affirm the patients that they are there. Thus, this makes the findings confusing and does not effectively answers the question.
According to Lord, Livingston & Cooper (2015) there are both barriers and facilitators faced by family carer decision making for the dementia patient. The article aimed at conducting systematic analysis of dementia family carer in decision making. The findings show that decision made without the wish of the care recipient can be distressing and increases the burden on the caregivers. This finding can act as a supporting evidence for answering the topic that the patients facing dementia should be included in care decision making. However, the findings lack information in benefits of involvement of dementia patient and the ways of participation. The article lacks in answering the topic to some extent.
The involvement of people facing dementia in forming healthcare decision-making has also been analyzed by Petriwskyj et al., (2014). The article aimed at reviewing the involvement of family in care decision making for patients suffering from dementia in residential aged care. The findings of the article shows that collaborative decision-making is highly efficient in preparing for healthcare for dementia patient. This shows that the article effectively answers the topic that a decision involving the patient, the family and the staff intend to give a better decision. This is because communication between these three individual is important for treatment decisions. However, the article lacked clear evidence on stating whether involvement of patient facing dementia in decision-making will be effective or not. Thus, this article lacks the ability to answer the topic and prove the involvement of people facing dementia in healthcare.
Likewise,Dening, Jones & Sampson (2011) has stated in the paper the importance of advance care planning for people facing dementia problem. It aimed at analyzing the involvement of advance care planning in dementia care process. the findings of the article presents that advance care planning for dealing with dementia problem is important and has been supported in many regions. This is effective for the research topic to answer that decision making in dementia care should be in a planned manner with facilitator, professional and patients. However, the article did not discuss the importance of participants of patients in care planning activity and this will create limitations in answering whether patients should be included in dementia healthcare decision making.
There are further works on the care process of dementia people where Pulst, Fassmer&Schmiemann (2019) has analyzed the involvement of family in taking decision for transferring the people facing dementia from nursing home to hospital. The findings shows that the transferring or treatment decisions of people with dementia is influenced by experiences of the nursing home, patient’s individual preferences, family decision and relationship with nurses and relatives. The findings helps in understanding that while taking decision for dementia patient it is important for involving family and individual along with professionals and this is highly effective for the topic. However, the focus was majorly on family members involvement rather patients involvement and this will create barriers in answering the topic.
The aim of the study by Pecanac et al., (2018) was to analyze the factors contributing to decision-making process for the patients facing dementia along with involvement of the person. the findings of the research shows that there are five factors that influence decision making process with involvement of the patients such as knowing the patient, the culture, clarity of the role, need for support for caregiver and suitability of palliative care. The findings is effective in answering the topic that decision-making process for dementia is affected by various factors. However, the article failed to stated whether involvement of patients in such decision is important or not. This will reduce its creditability in answering the topic.
Conclusion
Therefore, from the analysis on health care essay it can be stated that most of the article has supported the involvement of patients in health care decision making for dementia patients with effective evidence. However, there is still gaps in this area where there are researches that has shown the importance of decision-makingin dementia care process, however, failed to discuss the involvement of the patients in the decision process.
References
Barker, S., Lynch, M., & Hopkinson, J. (2017). Decision making for people living with dementia by their carers at the end of life: a rapid scoping review. International journal of palliative nursing, 23(9), 446-456. doi.org/10.12968/ijpn.2017.23.9.446
Daly, R. L., Bunn, F., & Goodman, C. (2018). Shared decision-making for people living with dementia in extended care settings: a systematic review. Health care essayBMJ open, 8(6). doi.org/10.1136/bmjopen-2017-018977
Dening, K. H., Jones, L., & Sampson, E. L. (2011). Advance care planning for people with dementia: a review. International Psychogeriatrics, 23(10), 1535-1551. 10.1017/S1041610211001608
Fetherstonhaugh, D., Tarzia, L., & Nay, R. (2013). Being central to decision making means I am still here!: The essence of decision making for people with dementia. Journal of aging studies, 27(2), 143-150. . doi.org/10.1016/j.jaging.2012.12.007
Lord, K., Livingston, G., & Cooper, C. (2015). A systematic review of barriers and facilitators to and interventions for proxy decision-making by family carers of people with dementia. International Psychogeriatrics, 27(8), 1301-1312. 10.1017/S1041610215000411
Mariani, E., Vernooij-Dassen, M., Koopmans, R., Engels, Y., &Chattat, R. (2017). Shared decision-making in dementia care planning: barriers and facilitators in two European countries. Aging & Mental Health, 21(1), 31-39.
Pecanac, K. E., Wyman, M., Kind, A. J., &Voils, C. I. (2018). Treatment decision making involving patients with dementia in acute care: a scoping review. Patient education and counseling, 101(11), 1884-1891. 10.1016/j.pec.2018.06.017
Petriwskyj, A., Gibson, A., Parker, D., Banks, S., Andrews, S., & Robinson, A. (2014). Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative literature. International journal of evidence-based healthcare, 12(2), 64-86.
Pulst, A., Fassmer, A. M., &Schmiemann, G. (2019). Experiences and involvement of family members in transfer decisions from nursing home to hospital: a systematic review of qualitative research. Health care essayBMC geriatrics, 19(1), 155.
Smebye, K. L., Kirkevold, M., &Engedal, K. (2012). How do persons with dementia participate in decision making related to health and daily care? A multi-case study. BMC health services research, 12(1), 241.
