Elin M. Aasen, Marit Kvangarsnes, Kåre Heggen

“Perceptions of patient participation among elderly patients

with end-stage renal disease in a dialysis unit”

Scandinavian Journal of Caring Sciences, 2012, 26, 61-69.


Elderly patients in a dialysis unit

Interviews with 11 older adults/patients (4 women, 7 men) 72 - 90 years.

Patient participation

The health-care teams have the power and dominance. The patients have a passive role.

Patients and health care staff

Conditions for participation are influenced by the context (environmental conditions).

In this study: feelings of being controlled, sensing a loss of freedom and powerlessness.

Combination of trust and fear can create passiveness and be a possible obstacle to communicate and shared decision making.


Elizabeth M.M. Tutton

“Patient participation on a ward for frail older people”

Journal of Advanced Nursing, 2005, 50, 143-152.


Hospitalized older adults

19 interviews with older adults/patients aged 60 were the majority were over 75 years. 3 FGD and 2 interviews with staff

Patient participation

Participation is a dynamic process that is integral to the work of nurses and carers. The process is enacted through the themes of facilitation, partnership, understanding the person, and emotional work

Patients and health care staff

Participation is not seen as a hierarchy but as a process that depended on the context of care giving. Partnership was an essential process in participation by identifying values and beliefs of the older adult and was also based on negotiation.


Julie P. W. Bynum, Laura Barre, Catherine Reed, Honor Passow,

“Participation of very old adults in health care decisions”

Medical Decision Making, 2014, 34, 216-230.


Subjects from regions with high and low

health care utilization.Subsidized housing, senior centers, and subsidize delder day care.

Semi structured interviews 29 older adults 80 - 93 years

Patient participation in health care decisions making in the clinical setting

decision making

A decision episode was defined as

Including a judgment about

taking or not taking an action.

Patients and clinicians ie. doctors

Participation varied among the patients, they participate to some degree and have the potential to be active participants in decision making. There is a need of open communication about options which could facilitate patients participations in health care decisions


Hanneke W. M. Van Laarhoven, Inge Henselmans, J. (Hanneke) C. De Haes

“To treat or not to treat: who should decide?”

The Oncologist, 2014, 19, 433-436.


Outpatient clinic

Case study

One older adults MR C

79 years old

Shared decision making

The focus should be put on the steps

taken for decision, not the amount of


A patient and a physicians

doctor at an outpatient clinic for oncological treatment

Some older adults can find it difficult to cope with the burden of decision making. Health care personnel can have to take on the responsibility for decision. However, it is critical to explore older adults’ values and adopt their perspective.