Advance Care Planning and Dying in Nursing Homes in Flanders, Belgium: A Nationwide Survey

Abstract

Prevalence of ACPs and formal authorization of a legal representative was low among the deceased NH residents in Flanders, Belgium. There was a higher prevalence of physicians' orders, often established after the resident had lost capacity. Initiatives should be developed to stimulate more advance discussion on care options and making end-of-life decision with the residents while they retain capacity.

Paramedics' experiences of end-of-life care decision making with regard to nursing home residents: an exploration of influential issues and factors

“…The participants recognised that a lack of documentation in nursing homes restricted their decision making, and their experiences suggested poor use of advanced care plans in nursing homes. There is variation in the use of advanced care plans in such care environments, but they have been shown to reduce admissions and deaths in hospitals 15 16…”

Forgoing artificial nutrition or hydration at the end of life: a large cross-sectional survey in Belgium

“…In addition, the patient's condition may preclude any meaningful communication by the time the subject is addressed. The significance of these decisions calls for a model of decision making involving ideally the consent of the patient or at least of the family in the context of advance care planning, which can still be improved in Belgium 22 23. This will help physicians face the ethical dilemmas and will make for more careful decision making.…”

Comparing Palliative Care in Care Homes Across Europe (PACE): Protocol of a Cross-sectional Study of Deceased Residents in 6 EU Countries

“…21,22 Using a 3-month period limits recall bias and has been successfully tested in previous research. 13,14,19,23 Additionally, to obtain a representative view of staff knowledge and attitudes regarding palliative care, we will conduct a cross-sectional study of staff (care assistants, nurses) working in the participating homes.…”