Care Planning Meetings with Older People: Issues for Policy, Social Work Practice and Patient Participation Symposium on Decision-Making Practices in Gerontological Social Work ESWRA 2019, Leuven

In recent years there have been national and international policy advances around capacity and decision-making and an apparent burgeoning human rights-based approach to the issue all of which have the potential to impact on the experiences of older people. There is little evidence however on whether these policies and principles are being translated into gerontological social work practice and whether traditional paternalistic approaches to decision-making are being challenged within our professional social justice remit.

Although Care-Planning Meetings (CPMs) are an increasingly common part of gerontological social work within multidisciplinary teams (MDTs), it is uncertain how, and by whom, the voice and wishes of older people, including those with a cognitive impairment, are given due priority. In addition, there is little professional guidance on how to best plan and facilitate CPMs for older patients with cognitive and communication deficits and other often complex needs. An added challenge is the wide, often diverse, and conflicting range of perspectives held by health and social care professionals and other family members who may be involved in the decision-making process.

The purpose of this presentation is to draw on best practices within the research literature as well empirical research on CPMs with older people carried out in the Irish context. This research highlights considerable variability in how older people participate and are involved in decision-making around their care. The findings show that family dynamics and existing relationships can also play a role in how older people participate and are involved. The facilitators and barriers to effective participation and decision-making for older people are considered and best practice guidelines for social workers in CPMs will be discussed which could help promote an individualised approach to participation that best reflects the older person’s will and preferences.