4.4 Article

Decision Regret among Informal Caregivers Making Housing Decisions for Older Adults with Cognitive Impairment: A Cross-Sectional Analysis

Journal

MEDICAL DECISION MAKING
Volume 40, Issue 4, Pages 416-427

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/0272989X20925368

Keywords

informal caregivers; decision regret; shared decision making; mixed linear model

Funding

  1. Canadian Frailty Network
  2. Tier 1 Canada Research Chair in SDM and Knowledge Translation [950-231200]
  3. VITAM -Centre de recherche en sante durable
  4. Fonds de recherche en sante du Quebec-Sante (FRQS)

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Background. Informal caregivers are regularly faced with difficult housing decisions for older adults with cognitive impairment. They often regret the decision they made. We aimed to identify factors associated with decision regret among informal caregivers engaging in housing decisions for cognitively impaired older adults.Methods. We performed a secondary analysis of cross-sectional data collected from a cluster-randomized trial. Eligible participants were informal caregivers involved in making housing decisions for cognitively impaired older adults. Decision regret was assessed after caregivers' enrollment in the study using the Decision Regret Scale (DRS), scored from 0 to 100. We used a conceptual framework of potential predictors of regret to identify independent variables. We performed multilevel analyses using a mixed linear model by estimating fixed effects (beta) and 95% confidence intervals (CIs).Results. The mean (SD) DRS score of 296 informal caregivers (mean [SD] age, 62 [12] years) was 12.4 (18.4). Factors associated with less decision regret were having a college degree compared to primary education (beta [95% CI]: -11.14 [-18.36, -3.92]), being married compared to being single (-5.60 [-10.05, -1.15]), informal caregivers' perception that a joint process occurred (-0.14 [-0.25, -0.02]), and older adults' not having a specific housing preference compared to preferring to stay at home (-4.13 [-7.40, -0.86]). Factors associated with more decision regret were being retired compared to being a homemaker (7.74 [1.32, 14.16]), higher burden of care (0.14 [0.05, 0.22]), and higher decisional conflict (0.51 [0.34, 0.67]).Limitations. Our analysis may not illustrate all predictors of decision regret among informal caregivers.Conclusions. Our findings will allow risk-mitigation strategies for informal caregivers at risk of experiencing regret.

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