Understanding Contextual Decision Making by Assisted Living Caregivers: Implications for Training and Design Supports

摘要

Many older adults reside in assisted living communities due to increased difficulty managing healthconditions or performing activities of daily living (e.g., bathing, toileting, walking). A primary goal ofassisted living communities is to help residents maintain their health and well-being. One method by whichthis is accomplished is that caregivers continually monitor residents for cues that might signal problems orconcerns, and then respond appropriately. However, very little is known about this form of decisionmaking done by caregivers working with assisted living residents, including whether decision makingchanges with increasing experience. To investigate these questions, direct care workers from assistedliving facilities took part in a scenario-based interview during which they responded to hypothetical caresituations with older residents. The explanations participants generated for the various scenarios wereclassified as either general or specific, with the majority of explanations coded as specific. Specificexplanations were primarily that the situation was the result of a physical health issue. The type andnumber of explanations varied widely from scenario to scenario. Lastly, the data from the current study didnot reveal consistent differences between the two levels of experience that were examined. This researchhas implications for the design of future training programs for direct care workers and also highlights thepotential need for decision support systems in this domain.