Experiences of people with memory disorders and their spouse carers on influencing formal care: "They ask my wife questions that they should ask me".
DEMENTIA 2021;
20:2307-2322. [PMID:
33595339 PMCID:
PMC8564245 DOI:
10.1177/1471301221994300]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background
People with memory disorders often need care and help from family carers and health and
social care providers. Due to the deterioration of cognitive capacity and language
skills, they may be unable to convey their thoughts and care preferences to other
people. As a result, their agency may become restricted. We investigated the
descriptions provided by people with memory disorders and spousal carers of their
influence on care in encounters with formal care providers.
Methods
Qualitative thematic analysis was used to identify, analyze, and report themes that
describe encounters with professionals in different social or healthcare environments.
In-depth interview data were gathered from 19 spouse carers and 15 persons with memory
disorders.
Findings
Three themes out of four describe how people with memory disorders and their spouse
carers influence formal care: Acquiescence, negotiating care decisions, and taking
control. The fourth theme describes lack of influence. People with memory disorders and
their spouse carers have ways to influence care, but spouse carers identified more ways
of doing so. Both either accepted and followed the care guidelines by the formal carers
or took control of the situation and made their own decisions. Spouse carers also sought
to influence care decisions through negotiations with formal carers. When formal carers’
decisions were experienced as inconsistent or the rationale of their actions difficult
to follow, the possibilities to influence care were limited.
Conclusions
People with memory disorders and their family carers are often in a disadvantaged
position as they lack power over the health and social care decision-making during the
illness, which is often guided by structural factors. To support the agency of people
with memory disorders and to promote shared decision-making, clarification of the
service structure and clearer communication between the different parties involved in
care are required.
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