To what extent are older people living with cancer involved in the decision-making process regarding treatment and support?

Lewis, Lucy Anne, Farrington, Naomi, Patel, Harnish and Bridges, Jackie (2019) To what extent are older people living with cancer involved in the decision-making process regarding treatment and support? Age and Ageing, 48 (1), 32-35. (doi:10.1093/ageing/afy204.13).

Abstract

Introduction: Improving cancer care for all is a priority. Comprehensive assessment is acknowledged as a useful means to identify comorbidities and functional challenges in older people living with cancer. Current studies mainly ascertain the benefits of risk identification and shared decision making amongst the cancer inter-professional team. Our aims were to examine the range and nature of literature exploring how and to what extent older people are involved in decision making relating to their cancer care.

Method: A scoping review of the literature from 2001 to present was executed using the methods defined by Arksey and O’Malley (2002). Systematic searches were conducted using the following online databases CINAHL, MEDLINE, PsychINFO and EMBASE to locate articles relating to the research question. The concepts were cancer, older people, complexity and qualitative research with corresponding synonyms. Qualitative studies were sought to provide an insight into people’s experiences.

Results: Preliminary findings indicate a number of factors that influence whether older people choose to accept or decline recommended treatment. These include relationship with physician: trust, communication and recommendations; possible adverse side effects of treatment and experiences of significant others as a consequence of treatment. None of the studies identified explicitly addressed the research question of this review. Nil focused on individual's experiences of decision-making.

Conclusion: We have identified significant gaps in the knowledge highlighting the need for further exploration of this important area. Increased understanding of older adults’ involvement in decision-making throughout the cancer trajectory will improve how health care professionals prioritise the preferences of the person in determining what they want from their health care. This will positively influence workforce development and service delivery to identify the need for a person centred approach to ongoing supportive treatment, recovery and/or anticipatory care planning for end of life.

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Contributors

Author: Lucy Anne Lewis

Author: Jackie Bridges

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