Home care providers' perceptions of shared decision-making with older clients (and their caregivers): A cross-sectional study

Interprofessional care teams can play a key role in supporting older adults (and caregivers) in making informed health decisions, yet shared decision making is not widely practiced in home care. Based on an earlier needs assessment with older adults (and caregivers) with home care experience, we aimed to explore the perceptions of home care teams on the decisions facing their clients and their perceived involvement in shared decision making. A cross-sectional study was conducted with 614 home care providers (nurses, personal support workers, rehabilitation professionals) in three Canadian provinces (Quebec, Ontario, and Alberta). Home care providers considered the decision to stay at home or move as the most difficult for older adults. Those most frequently involved in decision making with older adults were family members and least involved were physicians. Although all home care providers reported high levels of shared decision-making, we detected an effect of respondent's discipline on self-perceived shared decision-making; nurses and rehabilitation professionals reported significantly higher levels of shared decision making than personal support workers. A more tailored approach is required to support shared decision making in interprofessional care teams.

Automated summary

Interprofessional care teams play a key role in supporting older adults in making informed health decisions, but shared decision-making is not commonly practiced in home care. Researchers aimed to explore the perceptions of home care teams regarding their clients' decisions and their involvement in shared decision-making. The study found that the decision to stay at home or move was considered the most difficult for older adults by home care providers. Family members were the most frequent participants in decision-making, while physicians were the least involved. However, there were differences in self-perceived shared decision-making among different disciplines, with nurses and rehabilitation professionals reporting higher levels than personal support workers. The findings suggest a need for a more tailored approach to support shared decision-making in interprofessional care teams.