Development of a values-based decision aid to determine discharge destination: Case reports of older stroke survivors and their families

Older adults affected by stroke must face a difficult choice between receiving post-discharge care at home or in a facility. This study aimed to develop a decision aid (DA) to help older adults and their families choose the place of post-discharge care based on their values. METHODS: Values and data for designing the DA were obtained through interviews with older stroke patients and their families, a questionnaire survey of various health professionals, and a review of patients’ medical records. Next, a prototypic DA was prepared and tested for comprehensibility and usability using the 12-item International Patient Decision Aid Standards instrument. RESULTS: The DA was developed based on the following 6 values that were common among older stroke patients and their families: “activities of daily living,” “services and fees,” “emergencies,” “family support,” “environment,” and “home renovation.” The prototype met the criteria in the comprehensibility and usability tests. CONCLUSION: Older stroke patients can use the DA to think through the evidence-based information matching their own values to make a more satisfactory decision. The effectiveness of this DA should further be investigated in clinical settings.