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Development and evaluation of an aged care specific Advance Care Plan.
BMJ Support Palliat Care. 2013 Jun; 3(2):188-95.BS

Abstract

OBJECTIVES

To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention.

DESIGN

An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention.

PARTICIPANTS AND SETTING

19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria.

RESULTS

Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans.

CONCLUSIONS

Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.

Authors+Show Affiliations

Respecting Patient Choices, Austin Health, Heidelberg, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23626906

Citation

Silvester, William, et al. "Development and Evaluation of an Aged Care Specific Advance Care Plan." BMJ Supportive & Palliative Care, vol. 3, no. 2, 2013, pp. 188-95.
Silvester W, Parslow RA, Lewis VJ, et al. Development and evaluation of an aged care specific Advance Care Plan. BMJ Support Palliat Care. 2013;3(2):188-95.
Silvester, W., Parslow, R. A., Lewis, V. J., Fullam, R. S., Sjanta, R., Jackson, L., White, V., & Hudson, R. (2013). Development and evaluation of an aged care specific Advance Care Plan. BMJ Supportive & Palliative Care, 3(2), 188-95. https://doi.org/10.1136/bmjspcare-2012-000392
Silvester W, et al. Development and Evaluation of an Aged Care Specific Advance Care Plan. BMJ Support Palliat Care. 2013;3(2):188-95. PubMed PMID: 23626906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Development and evaluation of an aged care specific Advance Care Plan. AU - Silvester,William, AU - Parslow,Ruth A, AU - Lewis,Virginia J, AU - Fullam,Rachael S, AU - Sjanta,Rebekah, AU - Jackson,Lynne, AU - White,Vanessa, AU - Hudson,Rosalie, Y1 - 2013/03/15/ PY - 2013/4/30/entrez PY - 2013/4/30/pubmed PY - 2015/6/3/medline KW - Advance Care Planning KW - Advance Directives KW - Aged Care KW - End-of-life KW - Nursing Homes KW - Terminal Care SP - 188 EP - 95 JF - BMJ supportive & palliative care JO - BMJ Support Palliat Care VL - 3 IS - 2 N2 - OBJECTIVES: To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. DESIGN: An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. PARTICIPANTS AND SETTING: 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. RESULTS: Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. CONCLUSIONS: Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector. SN - 2045-4368 UR - https://www.unboundmedicine.com/medline/citation/23626906/Development_and_evaluation_of_an_aged_care_specific_Advance_Care_Plan_ L2 - https://spcare.bmj.com/lookup/pmidlookup?view=long&pmid=23626906 DB - PRIME DP - Unbound Medicine ER -