Shared decision making with frail older patients: Proposed teaching framework and practice recommendations

Area of Science:

• Gerontology
• Healthcare Education
• Clinical Communication

Background:

• Shared decision making (SDM) is crucial for older adults, particularly those who are frail.
• Existing models for SDM may not adequately address the unique needs of frail older patients.
• A need exists for structured training and competency development in SDM for this population.

Purpose of the Study:

• To identify core competencies for effective shared decision making (SDM) with frail older persons.
• To determine key elements for a teaching framework to support SDM with frail older patients.
• To develop practical recommendations for clinicians, educators, and researchers.

Main Methods:

• A qualitative inquiry was conducted involving 53 health professionals and 16 frail older patients.
• Participants identified core competencies and educational needs related to SDM.
• Literature review further explored identified themes and informed framework development.

Main Results:

• Core competencies for SDM with frail older adults were identified.
• A teaching framework was developed with key elements: knowledge base, practical training, communication facilitation, identifying discussion partners, patient engagement, and collaboration.
• Practice recommendations were formulated.

Conclusions:

• The developed teaching framework provides a structured approach to enhance SDM for frail older patients.
• The framework's elements can guide the training of health professionals to improve SDM skills.
• This resource can support clinicians, educators, and researchers in promoting SDM in geriatric care.