A CITIZENS JURY TO INFORM POLICY ON REHABILITATION FOR PEOPLE IN RESIDENTIAL CARE WITH HIP FRACTURE

Abstract It has long been recognised that eliciting the views and preferences of members of the public can improve health care decision making. One way of engaging members of the public in decision making is via Citizens’ Juries. Citizens’ Juries bring together a small group of people (jurors) who represent members of the public and ask them to consider a particular aspect of health care that is often complex (a ‘wicked’ problem). The aim of this jury was to consider (1) should there be an investment in physical rehabilitation services in residential care for older people following hip fracture? and (2) If so, what are some options for providing this service (considering funding, models of service delivery and equity)? A group of 13 jurors in Australia listened to presentations from expert witnesses including rehabilitation and palliative care specialists, a residential care provider, a health economist and three consumers. Following deliberation, all members of the jury agreed that there needs be a greater focus on promoting independence and rehabilitation in residential care and that upskilling of care staff is required. Twelve of the thirteen jurors agreed that in-reach rehabilitation services should be provided for this population with certain parameters. The remaining juror had reservations. The jurors felt that rehabilitation should not focus on physical recovery exclusively but should be flexible to meet the needs of the person; for some people this may include a greater focus on pain management or psychosocial rehabilitation. All jurors agreed that rehabilitation should take place in the residential care setting