scholarly journals A future care planning initiative to improve the end of life care of patients on the complex care ward of a district general hospital

2015 ◽  
Vol 2 (2) ◽  
pp. 87-89 ◽  
Author(s):  
Debbie Benson ◽  
Elena Mucci
Keyword(s):  
End Of Life ◽  
General Hospital ◽  
End Of Life Care ◽  
District General Hospital ◽  
Care Planning ◽  
Complex Care ◽  
Life Care ◽  
Future Care ◽  
Care Ward

scholarly journals 142 Advance Care Planning in Patients with Dementia: An Audit on End of Life Care in Hospital Deaths

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Rachel Sullivan ◽  
Clodagh Power ◽  
Elaine Greene ◽  
Roisin Purcell
Keyword(s):  
End Of Life ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Hospital Inpatient ◽  
Care Planning ◽  
Life Care ◽  
People With Dementia ◽  
Future Care ◽  
Advance Care ◽  
Resuscitation Status

Abstract Background End of life care (EOLC) planning is a difficult and often neglected area in dementia. Advanced care discussions play an important role in the planning of future care for patients with dementia. The NICE guidelines recommend that patients with dementia should be given every opportunity to discuss their wishes and preferences regarding their future care. The goal of our study was to explore the extent of EOLC planning in patients with dementia who died in hospital. Methods Patients with dementia who died in a large tertiary referral hospital in 2017 were identified via the Hospital Inpatient Enquiry (HIPE) database. A retrospective chart review was completed examining the documentation of Advance Care Planning (ACP) and discussions around end of life care. Charleston Comorbidity Index (CCI) was used to predict 1 year mortality. Results HIPE identified 49 patients with dementia who died in hospital. The average age was 84 and 53% were female. The commonest cause of death was respiratory (79.5%). Two thirds lived at home and 30% were nursing home residents. The mean CCI was 3.97 indicating 52% 1-year mortality, however only 34% were hospitalized in the last year. Only 14% had an ACP. Only 22% had resuscitation status recorded on admission. The majority had resuscitation status documented 15 days prior to death. In these cases 70% had clearly documented the discussion with family or patient and 84% documented ceilings of care 6 days prior to death. Palliative care were involved in 40% of cases. Two patients did not have resuscitation status documented prior to death and 3 received CPR. Conclusion Our study highlights the urgent need to facilitate conversations around end-of-life care with people with dementia. Advance care planning reduces the use of burdensome treatments, ensures dignity and comfort is prioritized enabling patients to live well until they die.

scholarly journals FUTURE CARE PLANNING AND END-OF-LIFE CARE DECISION MAKING: INDIVIDUAL AND SOCIAL INFLUENCES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S425-S425
Author(s):  
Jeong Eun Lee ◽  
Silvia Sörensen
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
End Of Life ◽  
Racial Differences ◽  
End Of Life Care ◽  
Current Evidence ◽  
Care Planning ◽  
Life Care ◽  
Future Care ◽  
Care Decision

Abstract As a growing number of older adults reach very old age, future care planning and end-of-life care decision making becomes increasingly important. Previous studies have shown that concrete future care planning steps are related to improved ability to manage illness and to better mental and physical health outcomes among older adults. Yet, relatively few older adults sufficiently plan for their future care. The purpose of this symposium is to highlight a collection of studies that each brings a unique perspective to the issue, reporting on individual and social factors that influence future care planning, end-of-life care decision making, and strategies to enhance future care planning among older adults. First, Chen and Siconolfi address common barriers and facilitators across diverse domains of age-related planning using content analysis. Second, Boerner and colleagues focus on the completion of formal planning without discussing the contents and factors associated with formal planning completion. Third, Strum investigates the complexities of navigating “fair” later life decisions involving family resources. Fourth, Moorman examines the racial differences in decisions of euthanasia and physician assisted suicide. Finally, Lee and colleagues report the findings from a future care planning intervention with older adults in rural area. The discussion by Sörensen will integrate the five papers with the goal of connecting the current evidence for meaningful steps in research and practice related to future care planning in older populations.

scholarly journals P-105 End of life care at the weekend in a uk district general hospital

2017 ◽  
Vol 7 (Suppl 1) ◽  
pp. A39.1-A39
Author(s):  
Katharine Perry ◽  
Holly Randall ◽  
Katherine Webb
Keyword(s):  
End Of Life ◽  
General Hospital ◽  
End Of Life Care ◽  
District General Hospital ◽  
Life Care

7 Exploring healthcare professionals’ attitudes to future care planning with older adults in hospital: qualitative research co-design through multi-professional patient and carer involvement

2018 ◽  
Vol 8 (3) ◽  
pp. 362.2-362
Author(s):  
Anna-Maria Bielinska ◽  
Stephanie Archer ◽  
Catherine Urch ◽  
Ara Darzi
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
List Type ◽  
Care Planning ◽  
Life Care ◽  
Topic Guide ◽  
Future Care ◽  
Advance Care

IntroductionDespite evidence that advance care planning in older hospital inpatients improves the quality of end-of-life care (Detering 2010) future care planning (FCP) with older adults remains to be normalised in hospital culture. It is therefore crucial to understand the attitudes of healthcare professionals to FCP in older patients in the hospital setting. Co-design with patients carers and healthcare professionals can generate more detailed meaningful data through better conversations.AimsTo co-design a semi-structured interview (SSI) topic guide to explore healthcare professionals’ attitudes to FCP with older adults in hospital.MethodsA multi-professional research group including a panel of patient and carer representatives co-designed an in-depth topic guide for a SSI exploring healthcare professionals’ attitudes to FCP with older adults in hospital.ResultsThe co-designed topic guide encourages participants to explore personal and system-level factors that may influence attitudes to FCP and practice in hospital amongst healthcare staff. Co-designed topics for inclusion in the SSI schedule include:Potential differences between specialist and generalist approaches to FCPThe influence of perceived hierarchy and emergency–decision making ability in professionals on FCP discussionsThe relevance to transitions of careAttitudes to FCP beyond the biomedical paradigm including perceived well–being and psychosocial aspects of careDigital FCP tools including patient–led FCP.ConclusionCo-designing qualitative research with older people and multi-disciplinary professionals may narrow translational gaps in implementing FCP by setting joint research priorities. Data generated from a co-designed study may expand understanding of hospital-based anticipatory decision-making with older adults.Reference. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ23 March 2010;340:c1345.

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