Collaborative Decision-Making

Older adults’ experiences with their healthcare are burdensome and often do not address what matters most. This dilemma arises because clinical decision-making is guided by single-disease guidelines rather than the health priorities of older adults. Most older adults have multiple chronic conditions that require a more collaborative approach to decision-making. The Model of Collaborative Decision-Making consists of two intersecting pathways. The first engages older adults to frame what matters to them into specific, realistic, and actionable health outcome goals based on the constraints of their personal lives and health trajectory. In the second pathway, older adults offer their preferences regarding which care is helpful and bothersome to inform clinician recommendations for care that aligns with patients’ health outcome goals. In this paradigm of priorities-aligned care, the value of healthcare derives from how well it achieves patients’ outcome goals, and its appropriateness is based on if patients are willing and able to use it. Patient Priorities Care is an evidence-based approach to collaborative decision-making for older, multimorbid adults and their clinicians. Patient Priorities Care results in care that is less burdensome and more aligned with the health outcome goals and care preferences identified by older adults. Patient Priorities Care holds promise as a favored healthcare approach for older adults with multiple morbidities.