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Characterizing Readiness for Advance Care Planning From the Perspective of Residents, Families, and Clinicians: An Interpretive Descriptive Study in Supportive Living.
Gerontologist. 2018 07 13; 58(4):739-748.G

Abstract

Background and Objectives

Advance care planning (ACP) involves reflection on health care preferences and communication of the person's wishes in case of future incapacity. ACP is particularly pertinent in supportive living (SL) as residents are at high risk of cognitive decline and changes in health status, but the readiness of residents, families, and health care practitioners to engage in ACP discussions is not known. The purpose of this study was to explore the readiness among these stakeholders and the factors that influence the degree of readiness.

Research Design and Methods

Twenty-seven participants (10 residents, 8 family members, 9 health care practitioners) affiliated with 4 SL facilities in Calgary, AB, Canada took part in semistructured, one-on-one interviews. An interpretive descriptive approach was utilized to generate clinically relevant findings.

Results

Variability in the conceptualization of ACP, including confusion regarding terminology, emerged as a major theme. Themes that influenced readiness for engagement in ACP discussions included the influence of prior experience for residents and family members, perception of treatment goals, and understanding of roles in the process between the groups.

Discussion and Implications

Recommendations for clinicians include clarifying ACP concepts for themselves and residents, shifting focus toward an elucidation of values and preferences rather than on documentation, greater clarity about the roles of the various stakeholders, and recognizing the importance of prior experience for residents and family members. These findings can be used to contribute to the understanding of ACP engagement in SL and inform an approach to engaging in meaningful discussions about ACP.

Authors+Show Affiliations

Community Health Science/Cumming School of Medicine, University of Calgary, Alberta, Canada.Faculty of Social Work, University of Calgary, Alberta, Canada.Community Health Science/Cumming School of Medicine, University of Calgary, Alberta, Canada.Faculty of Nursing, University of Calgary, Alberta, Canada.Community Health Science/Cumming School of Medicine, University of Calgary, Alberta, Canada.

Pub Type(s)

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

Language

eng

PubMed ID

28329800

Citation

Shaw, Marta, et al. "Characterizing Readiness for Advance Care Planning From the Perspective of Residents, Families, and Clinicians: an Interpretive Descriptive Study in Supportive Living." The Gerontologist, vol. 58, no. 4, 2018, pp. 739-748.
Shaw M, Hewson J, Hogan DB, et al. Characterizing Readiness for Advance Care Planning From the Perspective of Residents, Families, and Clinicians: An Interpretive Descriptive Study in Supportive Living. Gerontologist. 2018;58(4):739-748.
Shaw, M., Hewson, J., Hogan, D. B., Raffin Bouchal, S., & Simon, J. (2018). Characterizing Readiness for Advance Care Planning From the Perspective of Residents, Families, and Clinicians: An Interpretive Descriptive Study in Supportive Living. The Gerontologist, 58(4), 739-748. https://doi.org/10.1093/geront/gnx006
Shaw M, et al. Characterizing Readiness for Advance Care Planning From the Perspective of Residents, Families, and Clinicians: an Interpretive Descriptive Study in Supportive Living. Gerontologist. 2018 07 13;58(4):739-748. PubMed PMID: 28329800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterizing Readiness for Advance Care Planning From the Perspective of Residents, Families, and Clinicians: An Interpretive Descriptive Study in Supportive Living. AU - Shaw,Marta, AU - Hewson,Jennifer, AU - Hogan,David B, AU - Raffin Bouchal,Shelley, AU - Simon,Jessica, PY - 2016/09/01/received PY - 2017/3/23/pubmed PY - 2018/12/12/medline PY - 2017/3/23/entrez SP - 739 EP - 748 JF - The Gerontologist JO - Gerontologist VL - 58 IS - 4 N2 - Background and Objectives: Advance care planning (ACP) involves reflection on health care preferences and communication of the person's wishes in case of future incapacity. ACP is particularly pertinent in supportive living (SL) as residents are at high risk of cognitive decline and changes in health status, but the readiness of residents, families, and health care practitioners to engage in ACP discussions is not known. The purpose of this study was to explore the readiness among these stakeholders and the factors that influence the degree of readiness. Research Design and Methods: Twenty-seven participants (10 residents, 8 family members, 9 health care practitioners) affiliated with 4 SL facilities in Calgary, AB, Canada took part in semistructured, one-on-one interviews. An interpretive descriptive approach was utilized to generate clinically relevant findings. Results: Variability in the conceptualization of ACP, including confusion regarding terminology, emerged as a major theme. Themes that influenced readiness for engagement in ACP discussions included the influence of prior experience for residents and family members, perception of treatment goals, and understanding of roles in the process between the groups. Discussion and Implications: Recommendations for clinicians include clarifying ACP concepts for themselves and residents, shifting focus toward an elucidation of values and preferences rather than on documentation, greater clarity about the roles of the various stakeholders, and recognizing the importance of prior experience for residents and family members. These findings can be used to contribute to the understanding of ACP engagement in SL and inform an approach to engaging in meaningful discussions about ACP. SN - 1758-5341 UR - https://www.unboundmedicine.com/medline/citation/28329800/Characterizing_Readiness_for_Advance_Care_Planning_From_the_Perspective_of_Residents_Families_and_Clinicians:_An_Interpretive_Descriptive_Study_in_Supportive_Living_ L2 - https://academic.oup.com/gerontologist/article-lookup/doi/10.1093/geront/gnx006 DB - PRIME DP - Unbound Medicine ER -