10 ASSISTED DECISION-MAKING, THE OLDER ADULT, AND LOCUS OF CONTROL

Abstract

Abstract Background The Assisted Decision-making (Capacity) Act (ADMCA) (2015) will be fully commenced later in 2022. At its core, the legislation seeks to encourage the older adult to express their will and preferences regarding their healthcare decisions. The legislation removes healthcare decision-making powers from family members and healthcare professionals unless expressly nominated by the patient to make decisions on their behalf. However, a lack of clarity and professional uncertainty pervades this area in Ireland that is mirrored in the global research. Methods This qualitative study comprised 5 focus groups of hospital discharge coordinators in the South East of Ireland. It sought to examine the issues that exist for the older patient when they return home following a hospital stay. It also examined who really has responsibility for healthcare decision-making and who is responsible for providing the care? Thematic analysis was used to analyse the findings. Results The findings revealed a significant incongruence of beliefs among patients, family members and healthcare professionals when it comes to locus of control. Conclusion This study’s findings on locus of control – both in terms of where the discharge coordinators believe the locus is, and where they believe the families think it is - are the first of their kind in Irish Healthcare and are therefore highly significant in several respects. The substantive areas of disagreement in beliefs among the groups, represent real barriers to supporting ADMCA going forward.