OBJECTIVE: Develop a taxonomy for understanding and classifying goals
in the care of persons with dementia. DESIGN: Qualitative study using
open-ended interviews with key informants and the constant comparative
method of qualitative data analysis. SETTING: The geriatric assessmen
t center at a large academic medical center in Connecticut. PARTICIPAN
TS: Key informant interviews with 36 subjects: consecutive patients re
ceiving geriatric assessment at the center and their primary family ca
regivers, case managers, and physicians of patients. MEASUREMENTS AND
MAIN RESULTS: Goals, or desired outcomes, for the patient's care as de
scribed by patients, primary family caregivers, case managers, and phy
sicians were the main measurements. Participant interviews were conduc
ted until the point of theoretical saturation, i.e., until further int
erviews no longer provided new concepts. All participants articulated
at least one goal. Specific goals were characterized by a limited numb
er of goal attributes resulting in a taxonomy, or consistent classific
ation system, for reported goals. These attributes include domain (or
content), specificity, time frame, and level of challenge. CONCLUSIONS
: The findings suggested that patients, primary family caregivers, and
clinicians can articulate goals of care and may bring differing persp
ectives to the goal-setting process. The research identified a taxonom
y that may facilitate negotiation of goals by revealing important, and
perhaps overlooked, aspects of goals and the goal-setting process.