A Concept Analysis Relating to the Concept of Autonomy of Older People in Acute Care.

Despite living in an ageing population, ageist attitudes towards older people are common in society and even amongst those working in healthcare settings. Many Government policies and professional publications express the importance of older people’s right to autonomy; however this is as highly ambiguous concept. There also appears to be a paucity of evidence relating to the autonomy of this patient group in acute care. As such, this concept analysis aims to explore the concept of autonomy in adults aged over 65 in acute care in order to identify the defining attributes of autonomy, and determine a current definition of the concept in order to usefully inform practice. A range of sources were accessed including health and social care databases, internet sources, newspapers, television and books in order to identify all uses of the concept. From these sources the defining attributes of decision-making, the provision of information and choice were identified. It was discovered that when autonomy is present, individuals experience a greater sense of well-being, feel more empowered and enabled to provide informed consent and consequently care is patient-focused. In order for there to be autonomy in this particular patient group there needs to be a need to make a decision as an inpatient in acute care, the patient needs to participate in the decision-making process with individuality and freedom from coercion or restraint. It is also imperative that patients are listened to and their voice is heard. An awareness of what must and must not exist in order for patients to be autonomous is essential in helping nurses promote autonomy, recognise its existence and communicate effectively with others regarding the concept. A greater, and more consistent, understanding of the concept also gives meaning to policies and guidelines that express the importance of autonomy