A preliminary study on the development of care staff's Final-Stage Decision-Making Support Scale for older adults with dementia.

Aim: This preliminary study aimed to develop a care staff Final Life-Stage Decision-Making Support Scale (FS-DM) for older adults with dementia (OwDs) in geriatric facilities.

Methods: The FS-DM items were developed from focus group interviews with care staff and reviewed through discussions with several experts in dementia care. A questionnaire survey was conducted among care staff in geriatric facilities from February to March 2021.

Results: In total, 138 carers (110 [79.7%] women and 28 [20.3%] men, mean age: 41.5 ± 2.3 years) participated. Among them, 91 (65.9%) were professional caregivers, and 36 (26.1%) were nurses. The FS-DM was developed using a factor analysis, which resulted in 11 items grouped into three factors', as it is the three factors: (1) support for the realization of the wills of OwDs in their final life-stages through collaboration with families and multiple professionals; (2) consideration of communication regarding the formation and expression of the wills of OwDs in their final life-stages; and (3) support for eliciting the wills of OwDs during their final life-stages according to their decision-making ability and values. The factor loadings ranged from 0.385 to 0.827, and the accumulated contribution ratio was 61.03%. The reliability analysis yielded a Cronbach's α of 0.740-0.855. The first and second factors of the FS-DM were significantly correlated with the Approaches to Dementia Questionnaire item "Nurses' attitudes towards support for decision-making."

Conclusion: Our results suggest that the FS-DM could provide supportive care for OwDs to formulate, express, and realize their will, and that it has a degree of reliability and validity. Geriatr Gerontol Int 2024; 24: 130-134.