O’Shea, F., Weathers, E., & McCarthy, G. Family care experiences in nursing home facilities. (2014) [35] | Families | Explore relatives involvement in the care of older people admitted to RACF’s | Ireland | Interviews | PCC | Barrier Families excluded from participating in decision making. Staff task oriented not PCC. Interventions that engage residents and their families in care required. |
Sims-Gould, J., McKay, H., Feldman, F., Scott, V., & Ribonovitch, S. Autonomy, choice, patient-centred care and hip protectors: The experience of residents and staff in long term care. (2013) [36] | Residents and staff | Examine perceptions of staff and residents on the decision to use hip protectors and factors which influence decisions | Canada | Focus group (Part of a larger mixed methods study) | Evidence based information | Barrier Evidence based research took precedence over resident choice. Insistence on EBP even when explicitly declined by the resident. |
Tarzia, L., Fetherstonhaugh, D., Bauer, M., Beattie, E & Nay, R. “We have to work within the system!” Staff perceptions of organizational barriers to decision making for older adults with dementia in Australian aged care facilities. (2015) [37] | Staff | The perceptions of staff regarding organizational barriers that prevent facilitating decision making for residents with dementia | Australia | Semi-structured interviews and Focus groups. | PCC | Barrier Staff perceived there was not enough time to facilitate decision making and that education and training is required for the skills as a facilitator. Policies and procedures needed to support practice in facilitated decision making. |
Quantitative | ||||||
Ampe, S., Sevenants, A., Smets, T., Declercq, A & Van Audenhove, C. Advance care planning for nursing home residents with dementia: policy vs. practice. (2015) [38] | Staff | Evaluate advance care planning policy for people with dementia, and family involvement in advance care planning in practice | Belgium | Audit, self developed ACP questionnaire and OPTION scale | ACP | Barrier Staff failed to discuss the risks and benefits of treatment options with residents or their families. Strategies are required to translate ACP policy into practice. Staff training is required and greater family involvement recommended. Enabler Resident and family readiness for SDM was assessed on admission. |