A feasibility study of a decision aid to support family carers of people with severe dementia or those towards the end-of-life

Palliat Med. 2022 Oct;36(9):1432-1439. doi: 10.1177/02692163221122379. Epub 2022 Sep 8.

Abstract

Background: Advance care planning in dementia does not always happen. As dementia progresses, decisions are often left for family carers to make with professionals.

Aim: To test the feasibility and acceptability of the delivery and use of a decision aid for family carers of people with severe dementia or towards the end-of-life.

Design: Feasibility study using a before-after design of a paper-based decision aid with family carers of people with severe dementia or towards the end-of-life. Criteria for whether to progress to full evaluation included achieving: 70% recruitment rate of target of 30 people, and retention of 70% at 6 months. Outcome measures at baseline, 3 and 6 months, included: the Decisional Conflict Scale (DCS), Kessler Psychological Distress Scale (K10), EQ5D-5L and Satisfaction with Care at the End of Life (SWC-EOLD).

Participants: Twenty-eight family carers were recruited (93% of target), 26 completed baseline assessment and 20 (71%) of those were followed-up at 6 months.

Results: Almost all outcomes changed indicating improvement over 6 months. The DCS and K10 scores decreased indicating less decisional conflict and less psychological distress. The decision aid was acceptable, 25% found it very helpful and 55% a little helpful at 6 months.

Conclusion: We met the success criteria demonstrating this study was feasible and acceptable to carers. Future research should test the effectiveness of the decision aid in a full scale evaluation.

Keywords: Dementia; caregivers; decision support techniques; end of life care; palliative care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Caregivers* / psychology
  • Death
  • Decision Support Techniques
  • Dementia* / psychology
  • Feasibility Studies
  • Humans