Advance care planning in care homes: the experience of staff, residents, and family members

Stone, Louisa; Kinley, Julie; Hockley, Jo

doi:10.12968/ijpn.2013.19.11.550

Cited by 44 publications

(90 citation statements)

References 18 publications

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“…The articles that were included in the review were published between 2008 and 2015 and carried out in Australia (1 article),17 Belgium (2 articles),19,21 Norway (2 articles),22,23 UK (2 articles),18,20 and USA (2 articles) 15,16. Seven studies used semi-structured interviews,15,18–23 which were associated with focus groups in two cases,22,23 while one study consisted only of focus groups 16.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, one study used semi-structured interviews in the context of a case study 17. Five of the included studies were performed in long-term care facilities,17,18,20,22,23 while the remaining four15,16,19,21 recruited participants from other settings as well (ie, community center, acute geriatric ward, medical oncology ward, palliative care unit, and home services for older people). In two studies,17,20 a complex ACP intervention was carried out.…”

Section: Resultsmentioning

confidence: 99%

“…Five of the included studies were performed in long-term care facilities,17,18,20,22,23 while the remaining four15,16,19,21 recruited participants from other settings as well (ie, community center, acute geriatric ward, medical oncology ward, palliative care unit, and home services for older people). In two studies,17,20 a complex ACP intervention was carried out. Of the included studies, two addressed the older people perspectives;16,19 three addressed the family members’ perspectives;15,18,21 and four addressed both perspectives 17,20,22,23.…”

Section: Resultsmentioning

confidence: 99%

“…In two studies,17,20 a complex ACP intervention was carried out. Of the included studies, two addressed the older people perspectives;16,19 three addressed the family members’ perspectives;15,18,21 and four addressed both perspectives 17,20,22,23. Overall, the included studies involved135 elders and 133 family members or friends.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Perspectives of older people living in long-term care facilities and of their family members toward advance care planning discussions: a systematic review and thematic synthesis

Mignani

Ingravallo

Mariani

et al. 2017

CIA

115

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ObjectiveWe aimed to search and synthesize qualitative studies exploring the perspectives of older people living in long-term care facilities and of their family members about advance care planning (ACP) discussions.MethodsThe enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework was used to guide the review and report its results. PubMed, CINAHL, and PsycINFO were searched for studies published between January 2000 and November 2015. All included studies were assessed for comprehensiveness of reporting, and a thematic synthesis of their results was performed.ResultsThe nine included studies differed in terms of qualitative method used, comprehensiveness of reporting, and geographical origin. The thematic synthesis led to the identification of four main themes: 1) plans already made; 2) end-of-life care and decision-making; 3) opinions and attitudes toward ACP; and 4) how, when, about what, and with whom to do ACP.ConclusionDespite their willingness to be involved in a shared decision-making process, older residents and their families still have little experience with ACP.Practical implicationsIn view of implementing ACP for elders living in long-term care facilities, it would be important to rethink ACP and also to incorporate their nonmedical preferences, according to their own priorities.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Perspectives of older people living in long-term care facilities and of their family members toward advance care planning discussions: a systematic review and thematic synthesis

Mignani

Ingravallo

Mariani

et al. 2017

CIA

115

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“…Advance care planning and EOL experiences have been explored with NH residents. 21,22 Yet there remains limited research on these conversations from the perspective of older adults who reside in NHs. Therefore, the purpose of this study was to describe the communication, content and process, related to EOL conversations among residents, family, and staff.…”

Section: Introductionmentioning

confidence: 99%

Conversations about End of Life: Perspectives of Nursing Home Residents, Family, and Staff

Towsley

Hirschman

Madden

2015

Journal of Palliative Medicine

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Background: Care in nursing homes (NHs) often overlooks individual values and preferences. Residents' voices are critical to discussions about preferences, yet there remains limited research on conversations about the end of life (EOL) from the perspective of older adults who reside in NHs. Objective: The aim of this study was to describe the communication, content and process, related to EOL conversations among residents, family, and staff. Methods: We used semistructured interviews in this qualitative, descriptive study to describe conversations about EOL preferences. We examined participants' conversation, when it occurred, and what was discussed. We queried about barriers to and facilitators in discussing EOL care in the NH setting. We interviewed residents (n = 16), family (n = 12), and interdisciplinary staff (n = 10) from four NHs. Results: The overarching theme-missed conversations-describes EOL-related communication. Residents, families, and staff rarely talked about EOL care preferences, nor did they pass along information about preferences or initiate conversations about EOL care with each other. Three categories explained missed conversations: inquiry (''No one asked''); assumptions (presence of an advance directive [AD], ''They know me''); and conveying (lack of conveying information or wishes). Existing barriers and lacking facilitators resulted in missed opportunities to hold conversations about EOL preferences. Conclusions: Not all residents wanted to have conversations, but many wanted to be asked about their preferences. Missed conversations may adversely affect the quality of EOL care. Conversations with residents can be initiated by asking residents who they would like involved in the conversation and drawing upon the experience of others.

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Palliative Care in Residential Settings

Hockley¹

2018

Textbook of Palliative Care

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Advance care planning in care homes: the experience of staff, residents, and family members

Abstract: Care home staff need to develop the knowledge, skills, and confidence to engage in discussions around end-of-life care. The assistance of a trained facilitator who role-models this process should be explored.

Cited by 44 publications

References 18 publications

Perspectives of older people living in long-term care facilities and of their family members toward advance care planning discussions: a systematic review and thematic synthesis

Perspectives of older people living in long-term care facilities and of their family members toward advance care planning discussions: a systematic review and thematic synthesis

Conversations about End of Life: Perspectives of Nursing Home Residents, Family, and Staff

Palliative Care in Residential Settings

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