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Choices, Choices: Shared Decision Making Can Help

A woman and her aged father speak with a doctor

Shared Decision Making has important advantages for all Veterans.

by Long Term Services and Supports Team, VA Puget Sound
Monday, July 29, 2013

Making Decisions about Health Care in the Future

Do you need to make a decision about your health care or treatment in the near future? Do you want to be involved in making that choice? Then “Shared Decision Making” is for you.

“Shared Decision Making” ensures that the health care decision making process is centered on the patient. It involves family, support people and caregivers and the health care team including the social worker. It should be a collaborative process.

Watch this video, produced by the Informed Medical Decision Foundation, for an overview of Shared Decision Making.

What is “Preference Sensitive?”

When decisions are “preference sensitive” — meaning that what is important to you can be a key factor in the final decision — Shared Decision Making can help.

Examples of preference sensitive decisions include treatment choices for breast or prostate cancer as well as decisions about long term care also known as long term services and supports.

For shared decision making to work you need to:

  • Consider your needs
  • Learn about your options
  • Involve your family, caregiver, or other support person
  • Discuss possible choices with your health care team and social worker

Decision aids help you consider your needs and learn about your options in an unbiased way. Decision aids include information you need to make decisions, as well as tools to help you think about options. They can consist of online guides, printed materials, worksheets that help assess priorities and options and videos — used alone or in combination.

 I’m old enough to know what I want. 

Advantages of Shared Decision Making

When making decisions about long term care services and supports Shared Decision Making is a great approach. Three key advantages are:

  1. You can have a say in your care choices — using Shared Decision Making promotes self-determination and autonomy. If you are not informed and involved, someone else will be deciding for you.
  2. You may be able to avoid or relieve the burden on family caregivers — for example, if you have explored options and discussed your preferences with others, then it will be easier and less stressful for family members to help you make choices in a crisis situation.
  3. You may avoid or delay the need for institutional long term care — by getting the services you need in your own home. Many Veterans and family members are not aware of the range of services available and “tough” it out until the situation is serious and a nursing home seems like the only option.

Visit VA’s online Guide to Long Term Care to learn how Shared Decision Making can be used for long term care decisions. The Guide is a comprehensive decision aid and includes the information you need about long term care options in the home or other settings.

Read the overview of the Shared Decision Making process, and use the worksheets for Veterans and caregivers that will set you up for success when you talk with your VA health care team.

An elderly man and woman sit on a couch

Mary and Bob Hammar, 2013

“Avoid planning on the fly in a crisis.”

Korean War Veteran, Bob Hammar, says, “I used a decision aid to figure out what I wanted to do about my prostate cancer diagnosis in 2005. This year, I used decision aids to prepare for an appointment with my VA provider. My older brother, an Army Veteran, has been pretty healthy, but the reality is he’s 85. He told me to check out the VA’s online Guide to Long Term Care.

“From the Guide, I learned about options that might work for me both in my home and in my community near Tacoma, Washington. I especially liked the section on Shared Decision Making. I printed off the Worksheet for Veterans and filled it out. I’m old enough to know what I want, which is to make my preferences known while I still can. The Worksheet prompted me to consider a few things I hadn’t thought about.

“My wife, Mary, filled out the Caregiver Self-Assessment decision aid. We know our situation could change based on my health or hers. But, I’ve watched what’s happened with my friends and neighbors — heart failure, falls, all kinds of cancer and Parkinson’s. I may not be able to avoid a health crisis, but I can avoid planning on the fly in the midst of a crisis. I want to stay in my own home, if at all possible. And, I want to be prepared for the future. It’s really not that different than having our armed forces prepared to defend our great nation.”

“Maybe it’s time for you to think about how you might meet your long term care needs. I’m glad my brother told me to check out VA’s Guide to Long Term Care — even if he bleeds green and I bleed blue!”