Supporting Caregivers of Older Adults in Making Decisions: Current Tools and Future Directions

Family caregivers face many decisions as their older loved ones lose the capacity to function independently. The projected increase in the numbers of older adults with disabilities and cognitive limitations will result in higher caregiving demands, including decision making by caregivers. Knowing what decisions and challenges families face can help caregivers make decisions before crisis situations occur. Conversations between caregivers and their aging family member should start while the relative has the most faculties and capacity to share his/her goals and values are. In this chapter, we discuss how caregivers can work with healthcare providers and their loved ones to make positive, collaborative decisions, specifically focusing on four decision-making scenarios: (i) advance directives, do-not-resuscitate (DNR) orders, and power of attorney; (ii) decision making in families facing chronic illness and dementia; (iii) long-term-care (LTC) decision making; and (iv) end-of-life decision making. We review each type of decision making and suggest resources that could be used to inform as well as enhance the process.