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Advance care planning for nursing home residents with dementia: policy vs. practice.
- Source :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.); Mar2016, Vol. 72 Issue 3, p569-581, 13p
- Publication Year :
- 2016
-
Abstract
- Aims The aims of this study were: to evaluate the advance care planning policy for people with dementia in nursing homes; to gain insight in the involvement of residents with dementia and their families in advance care planning, and in the relationship between the policy and the actual practice of advance care planning. Background Through advance care planning, nursing home residents with dementia are involved in care decisions, anticipating their reduced decision-making capacity. However, advance care planning is rarely realized for this group. Prevalence and outcomes have been researched, but hardly any research has focused on the involvement of residents/families in advance care planning. Design Observational cross-sectional study in 20 nursing homes. Methods The ACP audit assessed the views of the nursing homes' staff on the advance care planning policy. In addition, individual conversations were analysed with ' ACP criteria' (realization of advance care planning) and the ' OPTION' instrument (involvement of residents/families). Data collection: June 2013-September 2013. Results Nursing homes generally met three quarters of the pre-defined criteria for advance care planning policy. In almost half of the conversations, advance care planning was explained and discussed substantively. Generally, healthcare professionals only managed to involve residents/families on a baseline skill level. There were no statistically significant correlations between policy and practice. Conclusion The evaluations of the policy were promising, but the actual practice needs improvement. Future assessment of both policy and practice is recommended. Further research should focus on communication interventions for implementing advance care planning in the daily practice. [ABSTRACT FROM AUTHOR]
- Subjects :
- MANAGEMENT
MEDICAL personnel
ATTITUDE (Psychology)
AUDITING
CHI-squared test
STATISTICAL correlation
DECISION making
DEMENTIA
HEALTH care teams
INTERVIEWING
LONG-term health care
RESEARCH methodology
PATIENT-professional relations
NURSING home patients
NURSING care facilities
PALLIATIVE treatment
RESEARCH funding
STATISTICAL sampling
STATISTICS
ADVANCE directives (Medical care)
SAMPLE size (Statistics)
PROFESSIONAL practice
EMPIRICAL research
QUANTITATIVE research
THEMATIC analysis
FAMILY roles
INTER-observer reliability
CROSS-sectional method
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 72
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 112462868
- Full Text :
- https://doi.org/10.1111/jan.12854