Improving older people’s involvement in health and in care decision-making.

This paper will present a synopsis of the evidence on older people’s involvement in their individual health and care; identify current positions, approaches and challenges to promoting positive ageing through increasing older people’s involvement in their care. Methodological and practical challenges to increasing older people’s involvement in care will be deliberated. Involvement in health and care decisions can improve a person’s quality of life and satisfaction, as well as increase care quality, safety and effectiveness. Across Europe people’s levels of involvement differs in type, method and priority (Picker Institute Europe 2009). Evidence exists that older people are not as involved as they would like to be in their care (Picker Institute Europe 2009), and that involvement in care improves personal outcomes: confidence, self-esteem and self-worth, as well as health-related outcomes: compliance, self-management and satisfaction (Hanley 2004; Barnard et al 2005). Many factors influence involvement; staff attitudes and structures that affect opportunities for involvement in decision-making are critical (Elwyn et al 2001; Arnetz et al 2008). Barriers to increased involvement in care can be addressed through education that develops staff knowledge, skills and attitudes, and through policies, strategies and structures that promote active engagement of people in their health and care decisions.