Components of the Advance Care Planning Process in the Nursing Home Setting

Mayahara, Masako; Miller, Arlene Michaels; O’Mahony, Sean

doi:10.1097/njh.0000000000000414

Cited by 15 publications

(11 citation statements)

References 28 publications

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“…Low patient compliance and decreased health quality may occur during the rehabilitation process [ 4 ]. For the first time, Mayahara M has carried out the continuous care model for cancer patients from the hospital to the home for the first time, a related study of nurses intervening in the early discharge of elderly patients [ 5 ]. Flanagan J imitates the concept of continuous care, including 6 dimensions (cross-institution, intergroup, mobility, vertical position, relationship, or individual continuity) to improve the quality of care for cancer patients [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Chen

Zhang

Li³

2022

Journal of Healthcare Engineering

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With the pollution of the environment and the acceleration of the social rhythm, the prevalence of tumors has increased year by year, and tumors have brought huge pain and inconvenience to patients. However, traditional nursing work consumes a lot of manpower and material resources, but it is difficult to improve the happiness of cancer patients, and it also brings a lot of troubles to many nursing workers. Based on the above reasons, we reengineered the traditional nursing process based on the BPR theory and applied the new process to the analysis of the management effect of cancer patients after oral chemotherapy drugs. The data shows that there are 23 patients with no pressure ulcer risk (score greater than 19) before care, 27 patients with low risk (15–19 points), 32 patients with moderate risk (13–14 points), and 18 people at high risk (less than 12 points). After nursing, there were 82 patients with no pressure ulcer risk, 10 patients with low risk, 7 patients with moderate risk, and 1 patient with high risk. This shows that the risk of pressure ulcers in patients with cancer after the use of chemotherapy drugs is significantly reduced compared with those without nursing. Nursing intervention can improve the psychological state of cancer patients during the recovery period, and nursing intervention can promote the compliance of cancer patients in various aspects of rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Chen

Zhang

Li³

2022

Journal of Healthcare Engineering

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“…Discussion and decision-making regarding EOL care are difficult for residents and their family members [ 4 ]. The results of this study indicated that when faced with decisions about EOL care, both residents and relatives wanted to talk to each other about the inevitability of a goodbye, the preference for a good death, and the question of going with or against traditional culture.…”

Section: Discussionmentioning

confidence: 99%

“…NH residents thus tend to have physical and mental comorbidities and often experience repeat hospitalisation. Therefore, concerns related to end-of-life (EOL) care are particularly relevant to Taiwanese NH residents [ 3 ], and to ensure preserve their autonomy at end of life, older residents should make use of advance directives (ADs) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

et al. 2022

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Background When older nursing home residents and their families are faced with end-of-life care decisions in Taiwan, they make them in the context of traditional cultural norms and socioeconomic changes. Both parties (residents and their family members) are often unwilling to broach the topic, leading to a decisional impasse. The aim of this study was to understand difficult-to-raise issues related to end-of-life care by investigating the perspectives of older nursing home residents and their family members. Methods This qualitative descriptive study was conducted using content analysis based on the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to select the participants, and sampling continued until data saturation. Data were collected using semi structured interviews, and related analyses were conducted using an inductive approach. Results Ten residents and twelve family members were interviewed individually. Six main themes were identified: (1) the inevitability of a goodbye; (2) a good death; (3) going with or against traditional culture; (4) better a good death than a bad life; (5) abiding by the residents’ decisions; and (6) being willing but unable to take care of residents. Conclusion Nursing home residents and their family members’ thoughts on end-of-life care shifted toward the concept of a good death, and they even regarded death as a form of liberation. Health care providers may serve as mediators to counsel a resident and their family members separately, enabling them to speak up and understand each other’s thoughts on end-of-life care before a decision is made so that neither party has regrets.

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“…[10][11][12] Promoting resident-centered and personalized care at EOL 13 involves conversations that focus on the resident's care preferences, such as hospital, nursing home, or hospice care at EOL, and not be limited to documenting advance directives, such as a do not resuscitate (DNR), do not hospitalize order, or naming a health care surrogate. 14 Nursing home (NH) residents, nonetheless, often postpone discussing their end-of-life preferences with family members, 10 or rely on family members to make decisions 15,16 assuming that they would know their care preferences at EOL. 6,7,10,13,17 Family members also may be unwilling to discuss EOL, a sensitive topic, with their NH relative or providers.…”

Section: Introductionmentioning

confidence: 99%

“…10-12 Promoting resident-centered and personalized care at EOL 13 involves conversations that focus on the resident’s care preferences, such as hospital, nursing home, or hospice care at EOL, and not be limited to documenting advance directives, such as a do not resuscitate (DNR), do not hospitalize order, or naming a health care surrogate. 14…”

Section: Introductionmentioning

confidence: 99%

Communicating With Nursing Home Residents About End of Life

Sopcheck

Tappen

2021

Am J Hosp Palliat Care

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Approximately 33% of the 1.2 million older individuals residing in nursing homes have the capacity to discuss their preferences for end-of-life care, and 35% will die within their first year in the nursing home. These conversations necessary to promote care consistent with the resident’s preferences are often limited and most often occur when the resident is actively dying. The purpose of this secondary analysis was to understand the resident’s perspectives on end-of-life communication in the nursing home and suggest approaches to facilitate this communication. We interviewed 46 participants (16 residents, 10 family members, and 20 staff) in a Southeast Florida nursing home from January to May 2019. The data were analyzed using descriptive and pattern coding and matrices to decipher preliminary categories and thematic interpretation within and across each participant group. Two themes emerged from this secondary analysis that residents assume others know their end-of-life preferences, and past experiences may predict future end-of-life choices. Residents and family members were willing to discuss end-of-life care. Study findings also suggested that past experiences with the end-of-life and critical illness of another could impact residents’ and family members’ end-of-life care decisions, and that nurses’ recognition of subtle signs of a resident’s decline may trigger provider-initiated end-of-life conversations. Future research should focus on strategies to promote earlier end-of-life discussions to support independent decision-making about end-of-life care in this relatively dependent population of older adults.

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Components of the Advance Care Planning Process in the Nursing Home Setting

Cited by 15 publications

References 28 publications

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering

Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study

Communicating With Nursing Home Residents About End of Life

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