Supporting effective shared decision-making with people with dementia

Shared decision-making is fundamental to person-centred dementia care but its practical application is often challenged by time, relationships, people's fluctuating capacity and organisational constraints. This article encourages nurses to reflect on the principles of shared decision-making in the context of dementia care, drawing on micro, meso and macro decision-making levels to illustrate how choices are shaped by personal values, culture, legal frameworks and the care environment. Using theory, a case study and time out activities, the article highlights how nurses can adopt communication and partnership approaches that prioritise the inclusion of people with dementia in decisions about their care. The authors also examine the emotional burden associated with the responsibility of families as decision partners, thereby supporting nurses to provide compassionate and culturally sensitive decision-making support.