Developing a Decision-Making Capacity Assessment Clinical Pathway for Use in Primary Care: a Qualitative Exploratory Case Study

  • Lesley Charles University of Alberta
  • Jacqueline MI Torti Western University
  • Suzette Brémault-Phillips University of Alberta
  • Bonnie Dobbs University of Alberta
  • Peter GJ Tian University of Alberta http://orcid.org/0000-0003-0682-082X
  • Sheny Khera University of Alberta
  • Marjan Abbasi University of Alberta
  • Karenn Chan University of Alberta
  • Frances Carr University of Alberta
  • Jasneet Parmar University of Alberta
Keywords: Decision Making Capacity Assessment, primary care, clinical pathway

Abstract

Background

With an ageing population, the incidence of dementia will in­crease, as will the number of persons requiring decision-making capacity assessments. For over 10 years, we have trained family physicians in conducting decision-making capacity assessments. Physician feedback post-training, however, has highlighted the need to integrate the decision-making capacity assessment process into the primary care context. The purpose of this study was to develop a decision-making capacity as­sessment clinical pathway for implementation in primary care.

Methods

A qualitative exploratory case-study design was used to ob­tain participants’ perspectives regarding the utility of a visual algorithm detailing a decision-making capacity assessment clinical pathway for use in primary care. Three focus groups were conducted with family physicians (n=4) and allied health professionals (n=6) in two primary care clinics in Alberta. A revised algorithm was developed based on their feedback.

Results

In the focus groups, participants identified inconsistencies and a lack of standardization regarding decision-making capacity assessments within primary care, and provided feedback regarding a decision-making capacity assessment clinical pathway to make it more applicable to primary care. Participants described this pathway as appealing and straight­forward; they also made suggestions to make it more primary care-centric. Participants indicated that the presented pathway would improve teamwork and standardization of decision-making capacity assessments within primary care.

Conclusions

Use of a decision-making capacity assessment clinical path­way has the potential to standardize decision-making capacity assessment processes in primary care, and support least in­trusive and least restrictive patient outcomes for community-dwelling older adults.

Author Biographies

Lesley Charles, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Jacqueline MI Torti, Western University

The Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry

Suzette Brémault-Phillips, University of Alberta

Department of Occupational Therapy, Faculty of Rehabilitation Medicine

Bonnie Dobbs, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Peter GJ Tian, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Sheny Khera, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Marjan Abbasi, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Karenn Chan, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Frances Carr, University of Alberta

Division of Geriatric Medicine, Department of Medicine

Jasneet Parmar, University of Alberta

Division of Care of the Elderly, Department of Family Medicine

Published
2021-02-18
How to Cite
Charles, L., Torti, J. M., Brémault-Phillips, S., Dobbs, B., Tian, P. G., Khera, S., Abbasi, M., Chan, K., Carr, F., & Parmar, J. (2021). Developing a Decision-Making Capacity Assessment Clinical Pathway for Use in Primary Care: a Qualitative Exploratory Case Study. Canadian Geriatrics Journal, 24(1), 26-35. https://doi.org/10.5770/cgj.24.400
Section
Original Research