P-136  Advance care planning and advance healthcare directives with a person with dementia

Abstract

to dementia service plans; To build collaborative and mutually supportive ways of working with local dementia services; To engage with the community in the development of Dementia Action Alliances. Conclusions Key learning from this process is that hospices need to be proactive to ensure their service is responsive to people with dementia. Community engagement and cross organisational working is crucial to this with the Hospice being involved in dementia service development and highlighting their commitment to equality of access for people with dementia and their families. Context People with dementia may receive sub-optimal end-oflife care (EoLC) in comparison with those who are cognitively intact (Lillyman and Bruce, 2016). Care home staff report feeling poorly-equipped to manage EoLC in dementia (Kupeli et al., 2016). Anecdotal evidence from the delivery of the ABC End of Life Care education programme for care homes by the Hospice of St Francis found challenges for staff included assessment, recognition of dying and symptom control. P-135The Dementia Nurse in Care Homes project aims to support care home staff in improving the quality of life of people with dementia and their families. A dementia nurse from the Hospice of St Francis will work in three specialist dementia units, a residential care home, a nursing home and a mental health care unit. Background Dementia is a progressive life-limiting illness. People with dementia value planning ahead. It allows them to express wishes and preferences and reduces anxiety. With the enactment of The Assisted Decision Making (Capacity) Act 2015 guidance in relation to advance care planning and advance healthcare directives with people with dementia is required by health and social care professionals. Methods An expert advisory group was established. A systematic literature review, searching online databases, CINAHL and PubMed was carried out. Grey literature was also accessed. The themes were presided on by the expert advisory group. Identified literature review themes directed the scope of the guidance. Results 288 articles were deemed appropriate. Post review with the expert advisory group the scope of the guidance document was extended to reach the person with dementia and family carers as well as healthcare staff across all settings.The themes from the literature include:1. Advance care planning and advance healthcare directives with people with dementia a. Advance care planning is difficult to engage in due to fluctuating capacity. 2. Family members:a. Uncertain about roles in advance care planning and having conversations. 3. Professional uncertainty a. Time constraints, lack of knowledge and understanding of dementia, advance care planning and legal responsibilities are factors.Guidance is offered on each on each of the above areas. Conclusion A guidance document has been prepared for health and social care staff to provide palliative care to people with dementia. The document will be published and made available via the Irish Hospice Foundation website.