Decision Regret and Decision-Making Process among Caregivers of Older Adults Receiving Home Care: A Cross-Sectional Study

Objectives: Family caregivers of older adults receiving home care often find themselves in situations in which they must make important and difficult decisions, which can cause conflict and regret. To tailor shared decision making in this context, we aimed to identify the most difficult decisions they faced, assess their levels of decision regret, and explore the associated factors. Design: This study used a cross-sectional design. Setting and Participants: Participants included 165 caregivers of older adults who received home care services in Korea. Methods: We identified difficult decisions perceived by family caregivers of older adults and evaluated decision regret using the Decision Regret Scale (DRS), decisional conflict using the Decisional Conflict Scale (DCS), burden of care using the Short Zarit Burden Inventory, and Preference Control Scale (PCS). We then performed descriptive, bivariate, and multivariate linear regression analyses to identify factors predicting decision regret. Results: The most frequently reported difficult decisions were related to place of living (71.6%), management of health conditions (15.1%), and end-of-life decisions (13.3%). The mean DCS score was 37.09 (12.67), the DRS score was 32.33 (15.91), and the burden score was 21.81 (8.25). Matching decisions with preferences and aligning decision-making roles significantly reduced regret, while decision conflicts increased regret. Conclusions and Implications: The positive associations between decision regret, decision conflict, and the alignment of decision-making roles highlight the intricate dynamics involved in the decision-making process for family caregivers. These findings emphasize the need for tailored interventions that recognize and address the diverse factors influencing caregivers' decision-making experiences. Future research exploring the efficacy of targeted interventions such as decision-support programs or caregiver education initiatives could offer valuable insights into mitigating decision-related challenges and improving the overall well-being of both caregivers and care recipients. (c) 2024 AMDA- The Society for Post-Acute and Long-Term Care Medicine.