Background
Many people living with dementia rely on long-term support in care homes. Decisions made in care homes are not limited to medical treatment and often include everyday choices about routines, meals, activities, personal care, visitors, safety and social relationships. These decisions can have a significant impact on dignity, independence, identity and quality of life. Although shared decision-making and person-centred care are widely promoted in policy and practice, people living with dementia are not always fully involved in decisions that affect them. Family carers and care home staff can also be uncertain about their roles in the decision-making process. There is a need to better understand how residents, family carers and staff work together to support decision-making in everyday care-home settings.
Aims and Objectives
This PhD study aims to explore how residents living with dementia, family carers and care-home staff collaborate in shared decision-making within dementia care homes.
The objectives are to:
- Explore how residents, family carers and staff understand collaboration and shared decision-making in care-home settings.
- Examine how everyday interactions and routines influence involvement in decisions.
- Identify barriers and facilitators that affect collaborative decision-making.
- Develop evidence to inform future resources or tools that support person-centred decision-making in dementia care homes.
Methods
This exploratory qualitative PhD study will work with people living with dementia, family carers and care-home staff in participating care homes.
The study will use:
- Interviews with residents, family carers and care-home staff to understand experiences and perspectives on collaboration and shared decision-making.
- Non-participant observation of everyday care-home interactions and routines to understand how decision-making occurs in practice.
- The findings will be used to identify practical barriers and enablers to collaborative decision-making and to inform future development work.
Further Information
This project is led by Marilyn Martey, a PhD Candidate at University of Bradford, under the supervision of Dr Catherine Quinn.
The study forms part of the NIHR ARC Yorkshire & Humber Health and Care in our Ageing Society theme and focuses on Dementia.
The research is expected to contribute to understanding how shared decision-making can be better supported in dementia care homes and will inform the future development of a practical resource or toolkit for residents, family carers, care-home staff and managers. Potential outputs may include guidance, reflective prompts, communication principles and decision-support materials that help promote collaborative, person-centred care.
Findings will be shared through the PhD thesis, academic publications, conference presentations, accessible summaries and engagement with care-home stakeholders. Interim findings will also be disseminated through blogs, conferences and ARC Yorkshire & Humber communication channels where appropriate.
Study period: October 2025 to Autumn 2028 (anticipated PhD completion).