A taxonomy for goal setting in the care of persons with dementia

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Abstract

OBJECTIVE

Develop a taxonomy for understanding and classifying goals in the care of persons with dementia.

DESIGN

Qualitative study using open-ended interviews with key informants and the constant comparative method of qualitative data analysis.

SETTING

The geriatric assessment center at a large academic medical center in Connecticut.

PARTICIPANTS

Key informant interviews with 36 subjects: consecutive patients receiving geriatric assessment at the center and their primary family caregivers, case managers, and physicians of patients.

MEASUREMENTS AND MAIN RESULTS

Goals, or desired outcomes, for the patient's care as described by patients, primary family caregivers, case managers, and physicians were the main measurements. Participant interviews were conducted until the point of theoretical saturation, i.e., until further interviews no longer provided new concepts. All participants articulated at least one goal. Specific goals were characterized by a limited number of goal attributes resulting in a taxonomy, or consistent classification system, for reported goals. These attributes include domain (or content), specificity, time frame, and level of challenge.

CONCLUSIONS

The findings suggested that patients, primary family caregivers, and clinicians can articulate goals of care and may bring differing perspectives to the goal-setting process. The research identified a taxonomy that may facilitate negotiation of goals by revealing important, and perhaps overlooked, aspects of goals and the goal-setting process.

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