scholarly journals Association between Advance Care Planning by a Visiting Nurse and Achieving the Desired Place of Death for Patients with End-stage Cancer

2017 ◽  
Vol 37 (0) ◽  
pp. 123-131 ◽  
Author(s):  
Takako Ishikawa ◽  
Sakiko Fukui ◽  
Yuko Okamoto
Keyword(s):  
Advance Care Planning ◽  
Place Of Death ◽  
Care Planning ◽  
Advance Care ◽  
End Stage ◽  
Visiting Nurse

Association of advance care planning with place of death and utilisation of life-sustaining treatments in deceased patients at Taipei City Hospital in Taiwan

2020 ◽  
pp. bmjspcare-2020-002520
Author(s):  
Yung-Feng Yen ◽  
Ya-Ling Lee ◽  
Hsiao-Yun Hu ◽  
Wen-Jung Sun ◽  
Ming-Chung Ko ◽  
...  
Keyword(s):  
Cohort Study ◽  
Advance Care Planning ◽  
Place Of Death ◽  
Care Planning ◽  
City Hospital ◽  
Taipei City ◽  
Advance Care ◽  
Eol Care ◽  
To Receive ◽  
At Home

ObjectiveEvidence is mixed regarding the impact of advance care planning (ACP) on place of death. This cohort study investigated the effect of ACP programmes on place of death and utilisation of life-sustaining treatments for patients during end-of-life (EOL) care.MethodsThis prospective cohort study identified deceased patients between 2015 and 2016 at Taipei City Hospital. ACP was determined by patients’ medical records and defined as a process to discuss patients’ preferences with respect to EOL treatments and place of death. Place of death included hospital or home death. Stepwise logistic regression determined the association of ACP with place of death and utilisation of life-sustaining treatments during EOL care.ResultsOf the 3196 deceased patients, the overall mean age was 78.6 years, and 46.5% of the subjects had an ACP communication with healthcare providers before death. During the study follow-up period, 166 individuals died at home, including 98 (6.59%) patients with ACP and 68 (3.98%) patients without ACP. After adjusting for sociodemographic factors and comorbidities, patients with ACP were more likely to die at home during EOL care (adjusted OR (AOR)=1.71, 95% CI 1.24 to 2.35). Moreover, patients with ACP were less likely to receive cardiopulmonary resuscitation (AOR 0.36, 95% CI 0.25 to 0.51) as well as intubation and mechanical ventilation support (AOR 0.54, 95% CI 0.44 to 0.67) during the last 3 months of life.ConclusionPatients with ACP were more likely to die at home and less likely to receive life-sustaining treatments during EOL care.

scholarly journals Advance Care Planning With Patients Who Have End-Stage Kidney Disease: A Systematic Realist Review

2018 ◽  
Vol 56 (5) ◽  
pp. 795-807.e18 ◽  
Author(s):  
Peter O'Halloran ◽  
Helen Noble ◽  
Kelly Norwood ◽  
Peter Maxwell ◽  
Joanne Shields ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Advance Care Planning ◽  
Realist Review ◽  
Care Planning ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage

Prevalence of advance care planning in a resident run clinic in an underserved community.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24067-e24067
Author(s):  
Swetha Ann Alexander ◽  
Vinay Mathew Thomas ◽  
David Wu ◽  
Radhika Kulkarni ◽  
William Rabitaille
Keyword(s):  
Primary Care ◽  
African American ◽  
Advance Care Planning ◽  
Primary Care Clinic ◽  
Retrospective Chart Review ◽  
Care Planning ◽  
Care Clinic ◽  
Underserved Community ◽  
Advance Care ◽  
End Stage

e24067 Background: Advance Care Planning (ACP) ensures that patients receive care that is in line with their values and preferences. ACP is best done in the outpatient setting. Despite recognizing the importance of ACP, the rates of ACP completion continue to be low. We conducted a retrospective study to determine the rates of ACP in a resident run primary care clinic in Hartford, Connecticut, which serves the underserved community. We looked at patient characteristics to find correlation with ACP completion. We also aimed to determine the reasons which could decrease the completion of ACP. Methods: This was a retrospective chart review. Patients who met any of the inclusion criteria [i) Age>65 ii) End stage renal disease on dialysis iii) Metastatic/Recurrent cancer iv) End stage heart failure v) COPD Gold stage D] and were seen in the primary care clinic from September 1, 2019 to December 31, 2019 were selected. Their charts were reviewed to see if ACP was documented during primary care visits over the past two years. The demographics of the patients were noted. Subsequently, a survey was distributed to residents to determine the possible causes of low rates of ACP discussion. Results: The characteristics of the 373 patients included in the study are shown in Table 1. Only 14 (3.8%) of the 373 had documentation of ACP during their primary care visits. The characteristics of the 14 patients in whom ACP was done are as follows: Sex- Female 9/14 (64%); Ethnicity- Hispanic 10/14 (71%), African American 4/14 (29%); Religious Affiliation- Christian 13/14 (93%), None 1/14 (7%); Married/Partner 2/14 (14%). Patient demographics including sex (p 0.6), religious beliefs (p 0.8), and marital status (p 0.6) did not show any correlation with the likelihood of ACP completion. Of the 31 residents who answered the survey, the most commonly listed barriers to ACP completion were the following: lack of time to conduct these discussions (94%), forgetting to conduct ACP discussions (48%), and lack of training (19%). All the residents believed that ACP discussion was beneficial to patients and medical providers. Conclusions: The rates of ACP planning in our clinic are much lower than the national average. African American and Hispanics, who make up the majority of our clinic population, traditionally have had low rates of ACP completion. This is an important issue that needs to be addressed. Advance care planning training should be also be strengthened during residency. [Table: see text]

scholarly journals Barriers to Use of Palliative Care and Advance Care Planning Discussions for Patients With End-Stage Liver Disease

2019 ◽  
Vol 17 (12) ◽  
pp. 2592-2599 ◽  
Author(s):  
Nneka N. Ufere ◽  
John Donlan ◽  
Lauren Waldman ◽  
Jules L. Dienstag ◽  
Lawrence S. Friedman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Liver Disease ◽  
Advance Care Planning ◽  
Care Planning ◽  
End Stage Liver Disease ◽  
Advance Care ◽  
Barriers To Use ◽  
End Stage

scholarly journals Case-control study of end-of-life treatment preferences and costs following advance care planning for adults with end-stage kidney disease

Nephrology ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Marcus Sellars ◽  
Rachael L Morton ◽  
Josephine M Clayton ◽  
Allison Tong ◽  
Daveena Mawren ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Advance Care Planning ◽  
Case Control Study ◽  
Case Control ◽  
Treatment Preferences ◽  
Care Planning ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage ◽  
Control Study

scholarly journals Costs and outcomes of advance care planning and end-of-life care for older adults with end-stage kidney disease: A person-centred decision analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0217787 ◽  
Author(s):  
Marcus Sellars ◽  
Josephine M. Clayton ◽  
Karen M. Detering ◽  
Allison Tong ◽  
David Power ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Disease ◽  
Decision Analysis ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Care Planning ◽  
Life Care ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage
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