Lost voices: Using a case study to illustrate narrative inquiry: Research brief.

INTRODUCTION: In this study, we tested the feasibility of using a narrative inquiry - three-dimensional space inquiry to elicit the experiences of an adult family member who shared her journey of care and advocacy for her husband situated in a dementia care unit. BACKGROUND: The voices of family members are rarely heard in relation to their experiences about being included in or making decisions about their loved one's care. Shared decision-making has been an important patient-centred approach to nursing care since the 1990s; however, it is often not a reality in aged care facilities. METHOD: An interview was conducted with one adult family member using the three-dimension space that is inspired by narrative theorists to analyse the narrative. RESULTS: Three themes were identified in the responses: communication between staff and family, staffing in the dementia care unit, and loss of voice and shared decision making. CONCLUSION: Results of this study indicate that narrative inquiry supports the telling of personal experiences around a problem and then using that information to raise awareness of those issues that are not always heard but which are essential for change in health care policy and practice.

What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities?

AIM: This scoping literature review aimed to answer the question: What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities? BACKGROUND: Shared decision-making has been an important patient-centred approach to nursing care since the 1990s, yet it is becoming increasingly evident that it is still not the reality in aged care facilities fifty years on. Currently, it is not well understood how adult children participate in shared decision-making and the types of decisions they are required to make. DESIGN: A review of original research papers using Kable, Pich and Maslin-Prothero 12-step systematic approach to documenting a search strategy. METHOD: The researcher screened 597 articles from four databases, published in the English language, during the period 1985-2019. The researcher used the Mixed Methods Appraisal Tool version 2011 to determine the methodological quality of the included studies. The Joanna Briggs Institute QARI data tool was used to appraise the seven selected articles and thematically analyse findings, respectively. RESULTS: Four themes were highlighted: communication; staffing; being involved; and staff-family relationships. Despite these themes being apparent, families have limited opportunities to participate in shared health decision-making in regard to their parents' care. CONCLUSION: The findings from this literature show how shared decision-making is affected by the RACF environment. There is a need to find out and understand what is important from a family member's point of view to optimise shared decision-making and nursing care of the family member in residential aged care settings. RELEVANCE TO CLINICAL PRACTICE: The limited findings specific to the SDM experiences of adult children of parents in RACFs in this review could help staff and RACFs to develop strategies and staff training to encourage and facilitate the implementation of shared health decision-making with staff and families on older people's care.