Interventions for the empowerment of older people and informal caregivers in transitional care decision-making: short report of a systematic review

Abstract

Background: Care transitions across different settings necessitate careful decision-making for all parties involved, yet research indicates that older people and informal caregivers do not have a strong voice in such decisions. Objective: To provide a systematic overview of the literature about interventions designed to empower older people and informal caregivers in transitional care decision-making. Design: A systematic review (Prospero Protocol CRD42020167961; funded by the EU’s Horizon 2020 program). Data sources: Five databases were searched: PubMed, EMBASE, Web of Science, PsycINFO, and CINAHL. Review methods: The review included evaluations of empowerment in decision-making interventions for older people and informal caregivers facing care transitions, that were published from the inception of the databases up until April 2022. Data extractions were performed by two independent researchers and the quality of studies was assessed with the relevant JBI-critical appraisal tools. A narrative descriptive analysis of the results was performed. Findings: Ten studies, reporting on nine interventions, and including a total of 4642 participants, were included. Interventions included transition preparation tools, support from transition coaches, shared decision-making interventions, and advance care planning. Designs and outcomes assessed were highly diverse and showed a mix of positive and lacking effects. Conclusions: There is a lack of research on how to empower older people and their informal caregivers in transitional care decision-making. Empowerment in decision-making is usually not central in transitional care interventions, and effects on actual empowerment are mostly not assessed. Conclusions on how to empower older people and informal caregivers in transitional care decision-making cannot be drawn.