Dyadic Decision-Making in Advanced Parkinson's Disease: A Mixed Methods Study.

Area of Science:

• Neurology
• Gerontology
• Health Psychology

Background:

• Advanced Parkinson's disease (PD) necessitates complex healthcare and living arrangement decisions for individuals and their family caregivers.
• These decisions are often made within a family context, significantly impacting patient and caregiver well-being.

Purpose of the Study:

• To identify the types and timing of decisions made by dyads (person with Parkinson's [PWP] and caregiver) in advanced PD.
• To explore the perceived quality of these decisions from the perspective of both the PWP and the caregiver.

Main Methods:

• A mixed-methods approach was employed, combining semi-structured dyad interviews with individual completion of decision-making measures.
• Data were collected twice, with a six-month interval, to assess decision quality over time.

Main Results:

• Key decisions included increasing home care services, transitioning to assisted living, maintaining the current situation, and initiating hospice care.
• High decision quality was observed, evidenced by low decisional conflict and regret, with no significant statistical differences between dyad members.

Conclusions:

• Dyads facing advanced Parkinson's disease navigate significant life decisions with notable decision quality.
• Healthcare providers can enhance their support by understanding the specific decision-making challenges and needs of these dyads.