Supporting and Representing Older Adults in Healthcare and Financial Matters: Experiences of Informal Caregivers in the Netherlands with Decision-Making and Legal Measures
Year: 2026
Type: article
Study design: Observational Study
Abstract: As populations age, more older adults require support with decision-making, often relying on informal caregivers. This multi-methods study explores how informal caregivers in the Netherlands participate in healthcare and financial decision-making for older adults, what factors are associated with their involvement in the decision-making process, and how different legal measures facilitate their participation in decision-making. Drawing on survey data from 815 caregivers and 13 in-depth interviews, the study identifies various types of involvement – from supported to substituted decision-making – with mutual decision-making as a distinct category. Participation is affected by the type, complexity and impact of decisions, the older adult’s decision-making abilities, wishes and preferences, and the involvement of others. The need for legal authority varies by relationship and caregiving role. While ex lege measures generally suffice for medical decisions, financial matters often require voluntary measures, which appear inconsistently recognized in practice. When voluntary arrangements are not feasible, adult guardianship measures may offer legal clarity. Although some international rights bodies call for the abolition of substituted decision-making regimes like adult guardianship, this study highlights their practicality in certain contexts. The findings call for legal and policy frameworks that both empower informal caregivers and safeguard the well-being of older adults.
Source: Journal of Aging & Social Policy
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7161495871