title: Recognizing decision needs: first step for collaborative deliberation in dementia care networks.
abstract: OBJECTIVE
  This study describes the process elements of decision-making for dementia, in order to enrich a model to facilitate shared decision-making for professionals working with people with dementia and their informal caregivers.
  
  
  METHODS
  We performed a qualitative study based on secondary analysis of 117 interviews from 23 care networks consisting of people with dementia, their informal caregivers and professionals. Findings were compared to an existing model of collaborative deliberation.
  
  
  RESULTS
  We made an enhancement to the existing collaborative deliberation model, to include: (1) constructive network engagement, (2) recognizing the need for a decision, (3) defining what to decide on, (4) developing alternatives, (5) constructing preferences through deliberation and trying out alternatives, (6) multiple preference integration, and (7) evaluating decision-making.
  
  
  CONCLUSIONS
  In describing the process elements of decision-making in dementia, this empirical study proposes a modification of the model of collaborative deliberation for the context of dementia care. The adaptation highlights the special attention needed to recognize and define what to decide on, try out alternatives, and handle conflicting interests and preferences.
  
  
  CONCLUSIONS
  Professionals should be attentive to mark the start of the decision-making process and work with participants towards a shared view on the pressing matters at hand.
authors.affiliation: Research Group Innovating with Older Adults, Centre of Expertise in Health Care and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands. Electronic address: lm.groen-vande.ven@windesheim.nl.
authors.forename: Leontine
authors.initials: L
authors.lastname: Groen van de Ven
authors.affiliation: Research Group Innovating with Older Adults, Centre of Expertise in Health Care and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands.
authors.forename: Carolien
authors.initials: C
authors.lastname: Smits
authors.affiliation: Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA.
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.affiliation: Research Group Innovating with Older Adults, Centre of Expertise in Health Care and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands.
authors.forename: Marijke
authors.initials: M
authors.lastname: Span
authors.affiliation: Research Group Innovating with Older Adults, Centre of Expertise in Health Care and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Jukema
authors.affiliation: Care Organization IJssel-Vecht, Zwolle, The Netherlands; Department of Nursing Home Medicine and EMGO Institute for Health and Care Research, Free University Medical Centre Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Eefsting
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Department of Primary Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Myrra
authors.initials: M
authors.lastname: Vernooij-Dassen
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003142:Communication; D003299:Cooperative Behavior; D003657:Decision Making; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009426:Netherlands; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012919:Social Behavior