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Shared decision-making for older adults with cardiovascular disease

Warren D Backman1,2, Sharon A Levine3, Nanette K Wenger4,5,6

  • 1Veterans Affairs New England Geriatric Research Education and Clinical Center, Boston, Massachusetts.

Clinical Cardiology
|October 4, 2019
PubMed

Insights

Shared decision-making is crucial for older adults

Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Health Communication

Background:

  • Shared decision-making (SDM) is vital for cardiovascular care in older adults, involving patient-clinician communication, preference elicitation, and goal alignment.
  • Older adults face unique challenges in SDM, including potential cognitive impairment linked to cardiovascular disease.
  • Existing decision aids are effective but have limitations for this demographic.

Purpose of the Study:

  • To explore the nuances of shared decision-making in the cardiovascular care of older adults.
  • To identify challenges and considerations specific to implementing SDM in this population.
  • To suggest areas for improvement in SDM processes for elderly patients.

Main Methods:

  • Review of shared decision-making principles and their application in geriatric cardiology.
  • Analysis of common challenges and facilitators for SDM in older adults.
  • Evaluation of decision aids' effectiveness and limitations in this context.

Main Results:

  • SDM is frequently applicable in cardiovascular care for older adults with multiple treatment options.
  • Cognitive impairment and other factors present specific hurdles for SDM in this group.
  • Decision aids show promise but require adaptation for older populations.

Conclusions:

  • Improving SDM for older adults requires addressing communication skills, interdisciplinary collaboration, and patient-centered goal identification.
  • While systemic changes are beneficial, enhancing fundamental communication and teamwork offers significant potential.
  • Prioritizing patient values is paramount for effective SDM in geriatric cardiovascular care.

Keywords:
agedcardiovascular diseaseclinical decision-makingdecision aidsdecision-making capacityelderlygeriatric cardiologygeriatricsinformed decision-makingolder adultspatient centered careshared decision-making

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