ArticleJournal of the American Geriatrics Society2024
"What choice do we have?" Reactive and proactive decision-making for aging in place with dementia.
Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
9 citing papers in PubMed.
- Physical Function and Residential Relocation of Older Adults Living With Chronic Conditions.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Implementing virtual reality training for person-centered communication in dementia care: a longitudinal qualitative study.Innovation in aging · 2026Article
- Applying Home Time to Examine Outcomes for People Living With Dementia After Emergency Care.JAMA network open · 2025Article
- Dementia Caregivers' Perspectives on Technology's Place in Care Practices: Mixed Methods Survey.JMIR formative research · 2025Article
- An account of personal autonomy for people living with dementia.The Gerontologist · 2025Article
- Comparison of mortality and hospitalisation rates amongst older adults residing in professional foster families versus nursing homes: two parallel observational studies.Age and ageing · 2025Observational
- Perspectives of Patients and Care Partners on Benefits or Burdens of Delaying Dementia Progression.JAMA network open · 2025Article
- Aging in rural areas: balancing land, care, and connection of family caregivers of persons with dementia: a qualitative analysis.Innovation in aging · 2025Article
- Examining Care Network Characteristics in Older Adults' Relocation to Residential Care Settings.Innovation in aging · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundPromoting options for aging in place (AIP) has broad appeal to policymakers and professionals providing services to persons living with dementia (PWD). However, the benefits or burdens of AIP likely vary among individuals and families. We sought to describe factors influencing decision-making to age in place versus seek a higher level of residential care for PWD.
methodsA qualitative study was undertaken as part of a larger mixed-methods study utilizing semi-structured interviews with PWD, family care partners, and dementia clinicians. Interview transcripts were analyzed using qualitative content analysis with constant comparison. Sample size was determined by thematic saturation within subgroups.
resultsWe conducted 74 interviews among 14 PWD, 36 care partners, and 24 clinicians. Preferences for AIP were driven by (1) desire to preserve independence, (2) a sense that the "best care" is delivered by loved ones and in a familiar environment, (3) distrust and fear of care facilities, and (4) caregiver guilt. PWD and care partners frequently considered moving from home as a "last resort" and wanted to avoid planning for future care needs. Many decisions to move were reactive and triggered by patient safety events, physical dependency, or the loss of caregiver. Proactive decision-making was facilitated by (1) prior experience witnessing the challenges of caring for a person with advanced dementia in the home; and (2) having substantial financial resources such that participants could seek major home adaptations or avoid "lower quality" institutions.
conclusionsDecisions regarding care setting for PWD frequently do not feel like a choice and are made under imperfect conditions. Programs using AIP as an outcome measure should recognize the various patient-centered and non-patient-centered factors that influence such choices, and interventions should be designed to promote more informed and equitable decision-making for care setting in dementia.
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Registered trials
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