Abstract

Family caregivers make important healthcare decisions for patients with advanced dementia. Little is known, however, about the key factors influencing their decision-making. This article reviews what is currently known about factors that influence family caregiver healthcare decision-making in the context of the medical management of advanced dementia. These factors are conceptualized as related to decision-makers’ characteristics/resources (i.e., personal factors) and broader socio-organizational conditions within which the decisions are made (i.e., situational factors). The common personal factors include the patient’s medical condition, advance directives, caregiver knowledge about dementia, the influence of healthcare providers, and the patient/caregiver socio-economic resources. The situational factors include access to healthcare services and community supports. More research is needed to better understand how family caregivers make healthcare decisions in the context of advanced dementia and how these decisions influence the quality of patient life and care. Such knowledge could inform supportive interventions to help family caregivers better manage end-of-life dementia care.