A TAXONOMY FOR GOAL-SETTING IN THE CARE OF PERSONS WITH DEMENTIA

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.