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Gaining a Deeper Understanding about Nursing Home Residents’ Decision Making Abilities Can Improve Their Quality of Life

Not only is it important for residents in long-term care facilities to have the power to make their own decisions in daily living for their well-being, the ethical and legal protection of their autonomy to make these decisions is imperative. Many nursing home residents’ ability to make their own decisions is impaired due to cognitive decline. A recent study identified potential markets of impaired decision making by exploring the link between a variety of nursing home resident characteristics (including gender, age, race, mood, falls, injuries, hospitalizations, duration of stay, number of activities of daily living (ADL) requiring assistance, and diagnoses of dementia, anxiety disorders, and depression) and impaired (vs independent) decision making.

Researchers found several independent markets of impaired decision making in nursing home residents. Depressed, sad, or anxious mood; dementia; and greater need for help with ADLs were some of the independent markers of impaired decision making among nursing home residents. It is important to note that some of these markers, in particular mood, can be modified and addressing them can improve decision making.

The recent reform efforts by nursing homes has aimed to give nursing home residents more opportunities to make daily decisions, such as their meals and activities. The freedom to make these daily decisions can improve their quality of life and well-being. Federal guidelines also mandate that nursing home residents are entitled to make decisions about their daily activities and schedules. Moreover, ethical principles stress that a nursing home resident’s autonomy be respected for making decisions, so long as the resident is able to make these decisions. For these reasons, it is necessary that nursing homes allow residents adequate latitude to make daily decisions in accordance with their abilities. By striving to improve nursing home staff knowledge about resident decision making, as well as resident factors that influence decision-making performance, nursing homes can better ensure that residents have appropriate freedom to make their own decisions in their daily lives.