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  5. How are people with dementia involved in care-planning and decision-making? An Irish social work perspective
 
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How are people with dementia involved in care-planning and decision-making? An Irish social work perspective

Author(s)
Donnelly, Sarah  
Begley, Emer  
O'Brien, Marita  
Uri
http://hdl.handle.net/10197/9935
Date Issued
2018-03-15
Date Available
2019-04-15T08:13:39Z
Abstract
In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes. Data collection included a mixed method approach; an on-line survey of social workers from across the country who reported on their open caseload during the month of June 2015 (N = 38 social workers reporting on the experiences of 788 older people, of which 39% of older people had a formal diagnosis of dementia). In addition, semi-structured telephone interviews were conducted with social workers working in the nine Community Health Organisation areas (N = 21). Findings show that people with dementia were high users of social work services, accounting for 44.5% of the client group. Social workers reported that there were no standardised approaches to how Health and Social Care Professionals involved people with dementia in care planning and decision-making. Overall, people with dementia were more likely to be excluded from decision-making processes due to (i) assumptions that they lacked capacity, (ii) family members preferences that the person was not involved, (iii) communication difficulties, (iv) time constraints, (v) little or no opportunity given or (vi) the person delegated decision-making to others. Good practices were identified through multidisciplinary team approaches and formal care planning meetings. This research highlights variability in how people with dementia participate in decision-making around their care. It sheds light on existing barriers which challenge the full implementation of the Irish Assisted Decision-Making legislation; highlighting the need for appropriate guidance and education for Health and Social Care Professionals. The findings also show that family dynamics and existing relationships can play a role in how people with dementia participate and are involved. To ensure consistent opportunities for participation, effective practices and approaches to supporting the participation of people living with dementia in care planning needs to be developed and rolled out in all care settings through increased training and adoption of standardised approaches.
Type of Material
Journal Article
Publisher
Sage
Journal
Dementia
Volume
0
Issue
0
Start Page
1
End Page
19
Copyright (Published Version)
2018 the Authors
Subjects

Dementia

Capacity

Decision-making

Social work

Multidisciplinary tea...

Involvement

DOI
10.1177/1471301218763180
Language
English
Status of Item
Peer reviewed
This item is made available under a Creative Commons License
https://creativecommons.org/licenses/by-nc-nd/3.0/ie/
File(s)
No Thumbnail Available
Name

Dementia_Full_Article_Involving_People_in_Decision-Making_Donnelly,_Begley_and_O'Brien_2018__final_pre_publication_version.doc

Size

266.5 KB

Format

Microsoft Word

Checksum (MD5)

9f79f82922c4385f6304f143e61be6b4

Owning collection
Social Policy, Social Work and Social Justice Research Collection

Item descriptive metadata is released under a CC-0 (public domain) license: https://creativecommons.org/public-domain/cc0/.
All other content is subject to copyright.

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