Facilitating shared decision-making in rehabilitation planning with people with dementia

While impaired cognitive dysfunction is a primary feature of dementia, an individual's ability to make decisions is either allowed or denied according to the level of support and advocacy they are afforded. When undergoing rehabilitation following a health event, recovery can be complicated and protracted for an older person with dementia, and they may be deprived of opportunities to determine their rehabilitation goals and express preferences throughout their rehabilitation programme. Furthermore, nurses may face challenges in proactively supporting the person's self-determination in choosing rehabilitation goals, as well as in advocating for and enabling the person to make decisions about their rehabilitation programme. This article provides guidance on how nurses can create an enabling environment by using person-centred communication techniques to assess an individual's capacity for making choices, building their confidence and supporting them to make decisions about rehabilitation goals and activities. These approaches aim to place each person at the centre of decision-making during their rehabilitation journey.