HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hirschman, K. B. Articles by Karlawish, J. H. T. Search for Related Content PubMed PubMed Citation Articles by Hirschman, K. B. Articles by Karlawish, J. H. T.

Do Alzheimer's Disease Patients Want to Participate in a Treatment Decision, and Would Their Caregivers Let Them?

Correspondence: Address correspondence to Karen B. Hirschman, PhD MSW, Institute on Aging, 3615 Chestnut Street, Philadelphia, PA 19104. E-mail: hirschk{at}nursing.upenn.edu

Purpose: This study was designed to examine the factors associated with the preferences of Alzheimer's disease patients to participate in a decision to use an Alzheimer's disease-slowing medication and how involved their caregivers would let them be in this decision. Design and Methods: Interviews were conducted with 48 patients in the mild-to-moderate stage of Alzheimer's disease and their caregivers. Results: Ninety-two percent of patients indicated they would participate in an Alzheimer's disease treatment decision, whereas 71% of caregivers thought the patient would participate. Half of the caregivers who indicated that their relatives would participate had relatives who did not have the capacity to make the decision based on a consensus of three expert psychiatrists. Patients' insight into their diagnosis and prognosis, and having less cognitive impairment, being a female caregiver, and being a spousal caregiver were all associated with the likelihood that the patient would participate in the treatment decision. Patients talked about wanting to be involved in the process of making a treatment decision, whereas caregivers talked about assessing whether their relative could participate in the process of decision making. Implications: Mild-to-moderate stage Alzheimer's disease patients want to be involved in making treatment decisions, and caregivers are generally willing to involve them. Caregivers of Alzheimer's disease patients talk about patient participation in relation to elements of the capacity to make a treatment decision. Clinicians can provide guidance and education to assist caregivers in understanding how to assess their relatives' abilities to make decisions and navigate the decision-making process.

Key Words: Dementia • Decision making • Capacity • Patient participation

This article has been cited by other articles:

				H. L. Menne, S. S. Tucke, C. J. Whitlatch, and L. F. Feinberg Decision-Making Involvement Scale for Individuals With Dementia and Family Caregivers American Journal of Alzheimer's Disease and Other Dementias, March 1, 2008; 23(1): 23 - 29. [Abstract] [PDF]

				H. L. Menne and C. J. Whitlatch Decision-Making Involvement of Individuals With Dementia Gerontologist, December 1, 2007; 47(6): 810 - 819. [Abstract] [Full Text] [PDF]

				J. Hyde, R. Perez, and B. Forester Dementia and Assisted Living Gerontologist, December 1, 2007; 47(suppl_1): 51 - 67. [Abstract] [Full Text] [PDF]

				S. Horton-Deutsch, P. Twigg, and R. Evans Health care decision-making of persons with dementia Dementia, February 1, 2007; 6(1): 105 - 120. [Abstract] [PDF]

				K. B. Hirschman, J. M. Kapo, and J. H.T. Karlawish Why Doesn't a Family Member of a Person With Advanced Dementia Use a Substituted Judgment When Making a Decision for That Person? Am J Geriatr Psychiatry, August 1, 2006; 14(8): 659 - 667. [Abstract] [Full Text] [PDF]