Healthcare Decision Literature Review 2022

Running head: HEALTHCARE DECISIONS 1
Healthcare Decisions for Patients with Dementia
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HEALTHCARE DECISIONS 2
Healthcare Decisions for Patients with Dementia
This literature review is a synthesis of previous scholarly works on the topic. This
literature review takes into consideration several articles which seek to answer the question,
"Should a person living with dementia be involved in decision making regarding their
healthcare?" The journal articles chosen for this purpose have been written from 2014 – 2019.
Overall, this literature review provides detailed and well-synthesized arguments that seek to
answer the question.
Darby and Dickerson (2017) assessed the decision-making capacity of dementia patients
in their study. They found out that Dementia is a medical and clinical condition characterized by
a gradual memory loss leading to the inability of the patient to take care of themselves. They
determined the adverse effects Dementia has on an individual's cognitive processes like
behavior, language, memory, executive functions, and decision making. Therefore, the
deterioration of their mental capacity significantly affects their personality in a great way.
According to Hamdy, Depelteau, and Kendal-Wilson (2017), "dementia patients are
unpredictable in a way that they are not aware when catastrophic reactions occur."
Following the adverse mental issues affecting the personality of dementia patients,
numerous laws have been enacted to incorporate dementia patients in making decisions
concerning their healthcare. However, substantial proof links patients with Dementia to their
non-involvement in making decisions. Smebye, Kirkevold, and Engedal (2012) observed that
while some patient does not wish to be part of making decisions, others have the will but are
denied opportunities to participate. This review analyses the current literature regarding the

HEALTHCARE DECISIONS 3
arguments for or against the inclusion of dementia patients concerning decision making and
comes up with a valid conclusion on whether or not they should be included in decision making.
A study by Hauserer et al. (2015) determined the significance of involving patients with
Dementia in making decisions, especially concerning their healthcare. According to the study,
the involvement of the patients in decision making significantly improves outcomes by
enhancing the confidence of the patient on the decisions arrived at. Inclusive decision making is
essential for the treatment of chronic infections like Dementia, and the decisions made are
significant to the patient’s life. The findings of this study correspond to Smebye et al. (2012),
who asserts that even though dementia patients are viewed incompetent in making their own
decisions. However, involving them is crucial. The study explains that these patients might have
some "retained cognitive abilities which can enable them to make some informed decisions."
According to Miller, Whitlatch, and Lyons (2016), physicians have a significant role in assessing
the extent of the symptoms such as language difficulties, memory loss, diminished mental
ability, and slow processing speed, before determining whether or not the patient can cooperate
in decision making.
Vahdat et al. (2014) investigated the relationship between shared decision making and
patient outcomes. The found out that the inclusion of dementia patients in the decision in shared
decision making improved not only patient outcomes but also reduced medical costs.
Traditionally, it has been known for a fact that decision-making processes incur high costs and
contribute to poor patient outcomes because patients may be misdiagnosed (Rozzini et al., 2010).
Therefore, the values and preferences of patients will help cut down unnecessary costs, thereby
improve outcomes.