Professional perspectives on decision making about the long-term care of older people.

Brian Taylor, Michael Donnelly

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)


With the increasing pressure on social and health care resources, professionals have to be more explicit in their decision-making regarding the long term care of older people. This grounded theory study used 19 focus groups and 9 semi-structured interviews (99 staff in total) to explore professional perspectives on this decision-making. Focus group participants and interviewees comprised care managers, social workers, consultant geriatricians, general medical practitioners, community nurses, home care managers, occupational therapists and hospital discharge support staff. The emerging themes spanned context, clients, families and services. Decisions were often prompted by a crisis, hindering professionals seeking to make a measured assessment. Fear of burglary and assault, and the willingness and availability of family to help were major factors in decisions about living at home. Service availability in terms of public funding for community care, the availability of home care workers and workload pressures on primary care services influenced decision ‘thresholds’ regarding admission to institutional care. Assessment tools designed to assist decision making about the long term care of older people need to take into account the critical aspects of individual fears and motivation, family support, and the availability of publicly-funded services as well as functional and medical needs.
Original languageEnglish
Pages (from-to)807-826
Number of pages20
JournalBritish Journal of Social Work
Issue number5
Publication statusPublished (in print/issue) - 31 Oct 2006


  • Older people, risk assessment, decision making, long term care.


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