Factors associated with decision-making involvement in community-dwelling older care recipients

Despite a growing interest in decision-making by care recipients, few empirical studies have examined the everyday care decisions of community-dwelling older adults. This study aimed to examine the association of recipient- and caregiver-related factors with decision-making involvement of community-dwelling older care recipients.

We conducted secondary data analysis using publicly available cross-sectional data from a dyadic survey with care recipients aged ≥65 years and their primary caregivers in two regions of Japan, one urban and another rural, in 2003. In total, 643 pairs with no missing data on any variable were included in the analysis. The level of care recipients' perceived decision-making involvement was assessed using one dichotomized item (not involved or involved). We examined care recipient- and caregiver-related factors described by previous studies as having the potential to inhibit or facilitate care recipient's subjective decision-making involvement.

Of the care recipients, 60.2% were women, 72.2% were >75 years, and 83.7% were involved in decision-making. Of the primary caregivers, 72.0% were women, 49.0% were <65 years, and 47.9% were spouses. Multivariable logistic regression analysis showed that care recipients were more likely to be involved in decision-making when their caregivers respected their decisions (odds ratio = 3.03 [95% confidence interval: 1.90-4.86], P < 0.001). Care recipients with more care needs were less likely to be involved in decision-making than those with less care needs (odds ratio = 0.53 [95% confidence interval: 0.32-0.89], P = 0.015).

Our results suggest that family caregivers play a crucial role in increasing care recipients' decision-making involvement regarding daily care. Geriatr Gerontol Int 2022; 22: 876-882.