The tensions between risk and choice: Perspectives of Australian occupational therapists about informed choice when working with older people.

Introduction: Aged care in Australia is under scrutiny. In 2021, the Royal Commission into Aged Care Quality and Safety highlighted the need for increased informed choice. Occupational therapists working within residential and community aged care have a responsibility to provide informed choice to t...

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Publicado en:Australian Occupational Therapy Journal Vol. 73; no. 3; pp. 1 - 16
Autores principales: Viswanathan, Sathya, McMullen‐Roach, Sarah, Weeks, Scott, Murray, Carolyn M.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2026
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/1440-1630.70098
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        atl: The tensions between risk and choice: Perspectives of Australian occupational therapists about informed choice when working with older people.
      aug:
        au:
          Viswanathan, Sathya
          McMullen‐Roach, Sarah
          Weeks, Scott
          Murray, Carolyn M.
        affil: Health Services South, Christie Downs, ACH Group, Christie Downs South Australia,, Australia
      sug:
        subj:
          Occupational Therapists Psychosocial Factors
          Occupational Therapist Attitudes
          Decision Making
          Work Environment
          Occupational Therapy
          Health Services for Older Persons
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Australia
          Qualitative Studies
          Descriptive Research
          Purposive Sample
          Snowball Sample
          Semi-Structured Interview
          Interview Guides
          Pilot Studies
          Thematic Analysis
          Human Dignity
          Risk Management
          Physical Therapists
          Nutritionists
          Relational Autonomy
          Professional-Patient Relations
          Health Policy
          Communication Methods
          Descriptive Statistics
          Comparative Studies
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Introduction: Aged care in Australia is under scrutiny. In 2021, the Royal Commission into Aged Care Quality and Safety highlighted the need for increased informed choice. Occupational therapists working within residential and community aged care have a responsibility to provide informed choice to their clients. Knowing more about the perspectives of occupational therapists about informed choice with older people will provide insights into practice that may direct future training needs and best practice recommendations. This study therefore aimed to explore perspectives of Australian occupational therapists about informed choice when working with older people. Methods: A qualitative descriptive research design was employed. Through purposive and snowball sampling, 10 Australian occupational therapists who work in the aged care sector were recruited. They worked in both residential and community aged care. Data were collected face‐to‐face and via tele‐conferencing using semi‐structured interviews; data were analysed using reflexive thematic analysis. Consumer and Community Involvement: Consumers of occupational therapy services were not involved, but this is a recommendation for future research. Findings: The findings reflected tensions reported in the literature of managing multiple decision‐makers and fluctuating decision‐making capacity alongside professional responsibilities. Theme 1 described methods for raising client awareness of options, negotiating choices, exercising caution, and supporting dignity or risk. Theme 2 described the communication skills employed for promoting informed choice, and Theme 3 described the need for collaborative decision‐making. The final theme outlined the value of workplace policies, procedures, and documents for informed choice. Conclusion: Occupational therapists in aged care approach their practice using a person and family centred lens. They employ skilful communication, negotiation, and problem solving. However, tensions exist between managing professional responsibilities around risk and supporting informed choice. Aged care is complex, with ongoing need for training and supervision, and a community of practice for idea sharing and collective problem‐solving. PLAIN LANGUAGE SUMMARY: Informed choice in aged care means older people know enough about their health and care options to make their own decisions. This includes the legal right to accept or refuse services. Autonomy happens when people can decide for themselves without pressure from others. When aged care supports autonomy and choice, older people may have improved lives. In 2021, the Royal Commission into Aged Care Quality and Safety called for greater emphasis on informed choice in aged care. However, occupational therapists' perspectives about informed choice when working with older people are largely unknown. Researchers interviewed 10 occupational therapists who worked in both residential and community aged care to learn their views about informed choice. Four themes were developed about informed choice, including building trust, communicating clearly, and involving families in decisions. They also refer to and use policies and procedures, such as staying up‐to‐date, risk reduction, and meeting documentation requirements. The study found that occupational therapists need time and resources to communicate and collaborate, so they can maximise informed choice. It also showed the value of professional networks and shared learning to solve problems and generate ideas.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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