Advance Care Planning in Nursing Home Patients With Dementia: A Qualitative Interview Study Among Family and Professional Caregivers

2015 ◽  
Vol 16 (11) ◽  
pp. 979-989 ◽  
Author(s):  
Mirjam C. van Soest-Poortvliet ◽  
Jenny T. van der Steen ◽  
Giselka Gutschow ◽  
Luc Deliens ◽  
Bregje D. Onwuteaka-Philipsen ◽  
...  
Keyword(s):  
Nursing Home ◽  
Advance Care Planning ◽  
Qualitative Interview ◽  
Interview Study ◽  
Care Planning ◽  
Nursing Home Patients ◽  
Qualitative Interview Study ◽  
Advance Care

scholarly journals Thinking ahead – the need for early Advance Care Planning for people on haemodialysis: A qualitative interview study

2014 ◽  
Vol 29 (5) ◽  
pp. 443-450 ◽  
Author(s):  
Katherine Bristowe ◽  
Helen L Horsley ◽  
Kate Shepherd ◽  
Heather Brown ◽  
Irene Carey ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Qualitative Interview ◽  
Interview Study ◽  
Care Planning ◽  
Qualitative Interview Study ◽  
Advance Care

scholarly journals “Hope for the best, prepare for the worst”: A qualitative interview study on parents’ needs and fears in pediatric advance care planning

2016 ◽  
Vol 31 (8) ◽  
pp. 764-771 ◽  
Author(s):  
Julia Desiree Lotz ◽  
Marion Daxer ◽  
Ralf J Jox ◽  
Gian Domenico Borasio ◽  
Monika Führer
Keyword(s):  
End Of Life ◽  
Advance Care Planning ◽  
Qualitative Interview ◽  
Interview Study ◽  
Medical Emergency ◽  
Severe Illness ◽  
Care Planning ◽  
Care Providers ◽  
Qualitative Interview Study ◽  
Advance Care

Background: Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. Aim: We aimed to investigate parents’ views and needs regarding pediatric advance care planning. Design: We performed a qualitative interview study with parents of children who had died from a severe illness. The interviews were analyzed by descriptive and evaluation coding according to Saldaña. Setting/Participants: We conducted semi-structured interviews with 11 parents of 9 children. Maximum variation was sought regarding the child’s illness, age at death, care setting, and parent gender. Results: Parents find it difficult to engage in pediatric advance care planning but consider it important. They argue for a sensitive, individualized, and gradual approach. Hope and quality of life issues are primary. Parents have many non-medical concerns that they want to discuss. Written advance directives are considered less important, but medical emergency plans are viewed as necessary in particular cases. Continuity of care and information should be improved through regular pediatric advance care planning meetings with the various care providers. Parents emphasize the importance of a continuous contact person to facilitate pediatric advance care planning. Conclusion: Despite a need for pediatric advance care planning, it is perceived as challenging. Needs-adjusted content and process and continuity of communication should be a main focus in pediatric advance care planning. Future research should focus on strategies that facilitate parent engagement in pediatric advance care planning to increase the benefit for the families.

scholarly journals Impact of an Advance Care Planning Video Intervention on Care of Short‐Stay Nursing Home Patients

2020 ◽  
Author(s):  
Lacey Loomer ◽  
Jessica A. Ogarek ◽  
Susan L. Mitchell ◽  
Angelo E. Volandes ◽  
Roee Gutman ◽  
...  
Keyword(s):  
Nursing Home ◽  
Advance Care Planning ◽  
Care Planning ◽  
Short Stay ◽  
Video Intervention ◽  
Nursing Home Patients ◽  
Advance Care

scholarly journals Differences in advance care planning among nursing home care staff

2021 ◽  
pp. 096973302199418
Author(s):  
Gilissen Joni ◽  
Wendrich-van Dael Annelien ◽  
Gastmans Chris ◽  
Vander Stichele Robert ◽  
Deliens Luc ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Confidence Interval ◽  
Advance Care Planning ◽  
Self Efficacy ◽  
Odds Ratio ◽  
Mean Difference ◽  
Care Staff ◽  
Care Planning ◽  
Advance Care

Background A team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well. Objectives To examine to what extent engagement in advance care planning practices (e.g. conversations, advance directives), knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes. Design Survey study. Participants/setting The study involved a purposive sample of 14 nursing homes in Flanders, Belgium. Nurses, care assistants and allied care staff (e.g. social workers, physical therapists) completed a survey. Ethical considerations The study was approved by the University Hospital of Brussels (B.U.N. 143201834759), as part of a cluster randomized controlled trial (clinicaltrials.gov NCT03521206). Results One hundred ninety-six nurses, 319 care assistants and 169 allied staff participated (67% response rate). After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations (odds ratio 4; 95% confidence interval 1.73–9.82; p < 0.001) and documented advance care planning (odds ratio 2.67; 95% confidence interval 1.29–5.56; p < 0.001); differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses (estimated mean difference 0.13 (score range 0–1); 95% confidence interval 0.08–0.17; p < 0.001) and allied staff (estimated mean difference 0.07; 95% confidence interval 0.03–0.12; p < 0.001) scoring higher than care assistants. We found no significant differences regarding self-efficacy. Discussion While nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training. Conclusions Allied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage.

scholarly journals ‘Traversing difficult terrain’. Advance care planning in residential aged care through multidisciplinary case conferences: A qualitative interview study exploring the experiences of families, staff and health professionals

2021 ◽  
pp. 026921632110132
Author(s):  
Suzanne Rainsford ◽  
Sally Hall Dykgraaf ◽  
Rosny Kasim ◽  
Christine Phillips ◽  
Nicholas Glasgow
Keyword(s):  
Advance Care Planning ◽  
Health Professionals ◽  
Aged Care ◽  
Shared Responsibility ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Planning ◽  
Qualitative Interview Study ◽  
Case Conferences ◽  
Advance Care

Background: Advance care planning improves the quality of end-of-life care for older persons in residential aged care; however, its uptake is low. Case conferencing facilitates advance care planning. Aim: To explore the experience of participating in advance care planning discussions facilitated through multidisciplinary case conferences from the perspectives of families, staff and health professionals. Design: A qualitative study (February–July 2019) using semi-structured interviews. Setting: Two residential aged care facilities in one Australian rural town. Participants: Fifteen informants [family ( n = 4), staff ( n = 5), health professionals ( n = 6)] who had participated in advance care planning discussions facilitated through multidisciplinary case conferences. Results: Advance care planning was like navigating an emotional landscape while facing the looming loss of a loved one. This emotional burden was exacerbated for substitute decision-makers, but made easier if the resident had capacity to be involved or had previously made their wishes clearly known. The ‘conversation’ was not a simple task, and required preparation time. Multidisciplinary case conferences facilitated informed decision-making and shared responsibility. Opportunity to consider all care options provided families with clarity, control and a sense of comfort. This enabled multiple stakeholders to bond and connect around the resident. Conclusion: While advance care planning is an important element of high quality care it involves significant emotional labour and burden for families, care staff and health professionals. It is not a simple administrative task to be completed, but a process that requires time and space for reflection and consensus-building to support well-considered decisions. Multidisciplinary case conferences support this process.

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