The 130th Annual Meeting of APHA

Abstract #41327

Marcie Weinstein, MBA, OTR/L¹, Nancy A. Miller, PhD², and Laura Drumm, MS, OTR/L¹. (1) Department of Occupational Therapy & Occupational Science, Towson University, 8000 York Road, Towson, MD 21252, 410-704-2321, mweinstein@towson.edu, (2) Policy Sciences Graduate Program, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250

Collaboration in health care decision-making is described as a process in which consumers and providers are mutually engaged in a respectful relationship, each contributing their expertise, and jointly sharing in the authority and responsibility for decisions. Collaboration is considered best practice, as its usage is associated with preservation of individual autonomy and improved health outcomes. However, collaborative attitudes frequently vie with long-standing paternalistic behaviors in many health care settings and practitioners. This paper describes an ongoing investigation of 200 consumers recently admitted to nursing homes for long-term care services, and focuses on their assessment of the degree of collaboration with which they and their health care providers approached the nursing home admission decision. Consumers under the age of 65 who had entered a nursing home within the past month were interviewed about their participation in the admission decision-making process, and more specifically, their attitudes and preferences for specific collaborative behaviors demonstrated by their providers. Initial examination of results reveals that this group of consumers overwhelmingly values collaborative relationships with providers in many aspects of decision-making, and significantly, relatively few report that their providers collaborated with them in the decision to enter a nursing home. Interviewees discussed their feelings with regard to their limited involvement in making major decisions about where to receive their care, and described the resulting impact on their preferences and outlook for the future. A number of factors related to the lack of collaborative decision-making have been tentatively identified.

Learning Objectives:

• Discuss consumer values and attitudes towards specific collaborative behaviors exhibited by health care providers.
• Describe the difference between consumer preferences for collaboration in nursing home admission decision-making with actual experiences.
• Identify four barriers to collaboration between consumers and providers in making decisions about nursing home admissions.

Keywords: Collaboration, Decision-Making

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.