Understanding Medical Care Decision-Making Among Ethnically Diverse Older Adults with Multiple Chronic Conditions

Patient-centered care involves assessing patient preferences. However, studying preferences alone will not ensure patient engagement in the decision-making process. This study identifies typologies of decision-making among older adults in comprehensive geriatric programs. We specifically focus on decision-making processes related to the patient’s reported medical encounters. methods: Forty older adults with multiple chronic conditions (MCC) were recruited from advanced care geriatric programs in Northern and Southern California. Researchers conducted three rounds of in-depth qualitative interviews in English and Spanish, completing 113 interviews over a 13-month period. The first interview was conducted face-to-face and lasted one hour on average. The second and third interviews were conducted over the phone and ranged in length from 20 – 90 minutes. preliminary findings: There were demographic differences between participants from the two health care sites. Notably, 50% of the Southern California cohort was Spanish-speaking and 25% was bilingual, with lower levels of formal education than the entirely English-speaking Northern California cohort. The Southern California cohort was less medically informed and less inclined to use technology or medical information sheets. The Northern California participants report being more proactive and engaging during the medical encounter and their decision-making process as compared to their Southern California counterparts. conclusion: Understanding how geriatric patients with MCC wish to be involved in medical care decision-making process requires tailored communication and assessment. Study findings can inform health care policy, including the development of decision-making tools to assist practitioners and patients during the decision-making process, and improve the geriatric medical care experience.