Competent Older Adults' Preferences in Healthcare Decision Making

Monday, 18 November 2019

Misae Ito, PhD, NMW
Yamaguchi University, Ube, Japan
Satoko Ono, MSN, RN
Department of Nursing, Kawasaki University of Medical Welfare, Kurashiki, Japan
Mana Sakai, MSN, RN, PHN
Department of Nursing, Kawasaki University of Medical Welfare Graduate School, Kurashiki, Japan
Eri Kataoka, MSN, RN
Department of Nursing, Kawasaki Medical School Hospital, Kurashiki, Japan
Keiko Hattori, PhD, RN
Faculty of Nursing, Gifu Shotoku Gakuen University, Gifu, Japan
Kyoko Murakami, PhD, RN, NMW
Graduate School of Medicine, Yamaguchi University, Ube, Japan
Keiko Matsumoto, PhD, RN
Kawasaki University of Medical Welfare, Kurashiki, Japan

The non-daily decision making in health care is required for patients with health problems and their family. The decision making process of patients are affected by the relations with a health care professional, but the influencing factors are various. The aim of this study is to investigate older adults’ thoughts of family involvement and its harmony among family in health care decision making. The participants who were over 65 years, competent for understanding, and had hospitalization experience, etc. were recruited.

Seven participants (4 females and 3 males) were interviewed from three out-patient clinics, and voluntary agreed with the study participation orally and in writing. The participants were asked to semi-structured interviews after approval for the study was obtained from the ethical committee from the author’s affiliated institution. Data were analyzed verbatim by content analysis.

Two of the older adults preferred to make health care decision by themselves, describing self-determination, and five preferred family involvement. The physician’s opinion for their health care decision making was most important. However, the family was demanded to be involved in the decision making and played a crucial role. The participants did not mind that they suffered from illnesses, tended to rely on a physician and decided to have a treatment. They did not fight against the illness and tried to spend naturally or live to true themselves. They appreciated family involvement until they became unwell, and appreciated family thinking of them sincerely. And they mostly did not want to trouble their family.

Self-determination is needed for older people in the super-aged society of Japan. This study reports on informed consent established in Japanese healthcare and the older person’s entrustment and reserve toward healthcare professionals because of the traditional ways of thinking. In addition, support based on the older person’s believes, values, and cultural background is important for the decision-making in healthcare.

This study was subsidized by Grant-in-Aid for Scientific Research (C) 26463226, 17K12105, Japan Society for the Promotion of Science.