6 OLDER ADULTS’ DECISION-MAKING CAPACITY FOR INDEPENDENT LIVING: OCCUPATIONAL THERAPY CONTRIBUTIONS TO COLLABORATIVE MULTIDISCIPLINARY ASSESSMENT

Abstract

Abstract Background Increasing age and life expectancy, alongside the growing prevalence of dementia-related diseases, indicate more older adults are likely to experience challenges regarding their decision-making capacity (DMC). The Assisted Decision Making (Capacity) Act 2015 provides a statuary framework for adults who are experiencing difficulties with decision-making and has implications for all healthcare professionals. Occupational therapists frequently contribute to multidisciplinary assessments of older adults’ DMC for independent living (IL). Methods Focus groups were conducted among occupational therapists working with older adults in Ireland to explore assessment practices of DMC for IL. Results Fifty-two occupational therapists, from a range of hospital and community settings, participated in nine focus groups. Therapists reported using enablement strategies and occupation-based approaches when assessing DMC to address the person’s values and preferences, cognitive-functional abilities and environmental needs for IL. However, resource issues and lack of shared understanding of DMC among the multidisciplinary team constrain DMC assessment practices. Furthermore, older people are often excluded from care-planning, and IL options are determined by availability of services rather than will and preference. Multidisciplinary education on DMC is essential in shaping a cohesive approach to assessment and to enhance older adults’ participation in decision-making. Conclusion Multidisciplinary collaboration and commitment to person-centred approaches may lead to enhanced outcomes for maximising and supporting older adult’s DMC regarding IL. A potential leadership role for occupational therapy in assessing DMC for IL is also highlighted.