Shared Decision Making is a structured process. It involves a patient, their informal caregiver (family or friend), social worker and care team working together to make health care and other related decisions.

This Guide tells you how to use shared decision making to make collaborative decisions about long term care needed now or in the future. It includes tools – the Shared Decision Making worksheet and the Caregiver Self-Assessment – that you fill out and use in discussions with your care team and social worker. And, the Guide includes Personal Stories of Veterans who have used shared decision making to make long term care choices.

Shared Decision Making involves the:

Veteran. You, the Veteran, are at the center of the  process. You decide who else is involved and you make the final decisions about your long term care.

Informal Caregiver. An informal caregiver is an unpaid person who is involved in your health care or daily living needs on a regular basis. The caregiver is often a spouse or adult child, but could be a close friend, faith advisor or other person involved in your life. You may have more than one caregiver. Only the most important caregiver should be involved in the shared decision making process. This person can offer new ideas and support as you think about your long term care options.

Social Worker. Your VA social worker can help you explore options that will best meet your long term care needs while supporting your preferred living situation. After you review the Guide, you can talk with your social worker on the phone, in-person or perhaps in a group session to review:

• Which services and settings are available through VA and the community
• Your eligibility for those services and settings
• How those services and settings meet you and your caregiver’s needs and preferences

Care Team. Key members of your care team are your physician, or other primary care provider, and your care manager (usually a nurse). Other members may include mental health professionals (psychiatrist or psychologist), a geriatrician and other specialists. They can answer questions about your health and how that relates to your long term care needs now and in the future.

Please click on these images to see Step 1.

Complete Step 1 of the Shared Decision Making worksheet

Answer the questions in this worksheet section to get a clearer picture of your long term care needs and preferred lifestyle.

Then, ask your primary caregiver to complete the Caregiver Self-Assessment. It will help them identify their own needs and think about what they can do to support you.

The Caregiver Self-Assessment is a supplement to the Shared Decision Making worksheet. It also has a number of steps that are easy to follow.

Using both of these tools in talks with your social worker and your care team is what makes the decision process a shared decision making process.

Please click on this image to see Step 2 of the worksheet.

Complete Step 2 of the Shared Decision Making worksheet

Use this Guide to explore your options:

• Review Home and Community Based Services and think about how those services could support you living at home.
• Review Residential Care options to think about whether or not living in a group residence is best for you.
• Visit Helpful Websites to further explore long term care services in VA and the community, and to locate services in your area.

Please click on this image to see Step 3 of the worksheet.

Complete Step 3 of the Shared Decision Making worksheet

Involve these people in your planning:

Caregiver
Ask your caregiver to share what they learned from completing the Caregiver Self-Assessment. Even though you may not always agree, your caregiver is probably familiar with your goals, values and lifestyle choices. And, their ability to provide support to you affects the long term choices you make.

Care Team
If you have questions about your health status, make an appointment to discuss that (by phone or in-person) with someone on your care team. Keep in mind that a referral from your physician, or other primary care provider, is needed for some VA long term care services and settings.

Social Worker
Talk with your social worker (by phone or in-person) about your long term care needs, your eligibility for services, the availability of services in your area and what long term care options may be best for you. Involve your caregiver in those discussions.

Please click on this image to see Step 4 of the worksheet.

Complete Step 4 of the Shared Decision Making worksheet

Identify the action steps you need to take to finalize your long term care plan.

Remember to support your informal caregiver in addressing their needs. Every VA medical center has at least one caregiver support coordinator. To learn more, caregivers can contact a caregiver support coordinator listed on the VA caregiver support website or visit the VA social work website.

Keep in mind that the choices you make today are not final. Your choices may change as other factors in your life change such as your health status or your caregiver's situation.

You can see how other Veterans went through the shared decision making process by going to Personal Stories.

Download the Shared Decision Making worksheet so you can complete it and use it in the shared decision making process.

You can:

• Print it out and complete it by hand.
• Open it and then save it on your computer, and then fill it out when you are ready.
• Or, you can complete it online and then save it to your computer. If you start filling it out online, be sure to save it on your computer so you can finish or revise it later.

Download the Caregiver Self-Assessment so you can complete it and use it in the shared decision making process.

You can:

• Print it out and complete it by hand.
• Open it and then save it on your computer, and then fill it out when you are ready.
• Or, you can complete it online and then save it to your computer. If you start filling it out online, be sure to save it on your computer so you can finish or revise it later