Invited review: Enabling shared decision making in gerontological nursing: Barriers and facilitators

Abstract

Shared decision making is globally recognized as an important concept in healthcare research, policy, education, and practice that enhances person-centered care. However, it is becoming increasingly evident that shared decision making has not been successfully translated into healthcare practices, especially in gerontological nursing. Central to person-centered and shared decision making is the need to recognize the importance of life experiences to inform decision-making processes. With the world’s aging population and older adults facing more complex decisions and transitions in care, it is important to integrate shared decision making into person-centered care for older adults. This invited paper reviews the key issues in shared decision making in the context of older persons and the role of nurses. The review was divided into three parts. The first describes and comments on the main theoretical frameworks, while the second and third deal with barriers and facilitators to shared decision-making of older persons and issues related to their practice. There is a critical demand for focused research on older individuals with intricate needs and family-centered approaches to shared decision making. The tools and resources that support shared decision-making such as adequate time, consultation services, culturally appropriate decision aids, and systems that track patient progress, are essential for effective decision-making. As shared decision making involves various community resources, nurses must not only educate patients about these resources, but also provide patients with advice and support to ensure that the patients can effectively access and utilize these resources.