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Making Care Decisions in Home-Based Dementia Care: Why Context Matters*

Published online by Cambridge University Press:  07 December 2012

Oona St-Amant ,
Catherine Ward-Griffin ,
Ryan T. DeForge ,
Abe Oudshoorn ,
Carol McWilliam ,
Dorothy Forbes ,
Marita Kloseck  and
Jodi Hall
Oona St-Amant*
Affiliation:
Arthur Labatt Family School of Nursing, The University of Western Ontario
Catherine Ward-Griffin
Affiliation:
Arthur Labatt Family School of Nursing, The University of Western Ontario
Ryan T. DeForge
Affiliation:
Health and Rehabilitation Sciences, The University of Western Ontario
Abe Oudshoorn
Affiliation:
Arthur Labatt Family School of Nursing, The University of Western Ontario
Carol McWilliam
Affiliation:
Arthur Labatt Family School of Nursing, The University of Western Ontario
Dorothy Forbes
Affiliation:
Faculty of Nursing, University of Alberta
Marita Kloseck
Affiliation:
School of Health Studies, The University of Western Ontario
Jodi Hall
Affiliation:
Health and Rehabilitation Sciences, The University of Western Ontario
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Oona St-Amant, R.N., M.ScN. Faculty of Health Sciences Arthur Labatt Family School of Nursing The University of Western Ontario Rm H004B, Health Sciences Addition London, ON N6A 5C1 ([email protected])
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Résumé

D’ici à 2038, le nombre d’heures de soins non rémunérées aux aînés offert par les membres de la famille devraient tripler. Les membres des familles sont souvent suppliés d’aider dans le processus parce que vivre avec la démence peut inhiber la capacité pour prendre une décision. Cette étude ethnographique a soumis les relations au sein de soins de la démence à domicile à un examen critique par le biais des entrevues face-à-face et les observations des participants des clients, des aidants naturels et des prestataires de soins à domicile. Les résultats ont révélé comment les décisions sont imposées dans le contexte du système de soins à domicile formels, et ont mis en évidence trois thèmes: (1) L’accommodation de la compétence/incompétence, comme définie cliniquement; (2) La prise de décisions inopportunes; et (3) Le renforcement de l’exclusion des déments dans la prise de décision. Ces thèmes illuminent la façon dont les valeurs culturelles (la compétence), les croyances (l’immuabilité du système) et les pratiques (le réglage des décisions) dans le système de soins à domicile sont finalement déterministes dans la prise de décisions pour les déments et leurs aidants. Afin d’optimiser la santé des déments qui se font soignés à domicile, il faut accorder d’attention supplémentaire aux pratiques collaboratives et inclusives des membres des familles.

Keywords

prestation de soinsprise de décisionsrelations familialesdémencesoins à domicilesoins infirmierscaregivingdecision makingfamily relationshipsdementiahome carenursing
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 4 , December 2012 , pp. 423 - 434
Copyright
Copyright © Canadian Association on Gerontology 2012 

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Footnotes

*

This study was funded by Canadian Institutes of Health Research (IA) and Alzheimer’s Society of Canada.

Disclosure: There is no conflict of interests/financial disclosures

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