Interventions to promote the use of advance directives: An overview of systematic reviews

Tamayo-Velázquez, María-Isabel; Simón‐Lorda, Pablo; Villegas, R.; Higueras-Callejón, Camila; García-Gutiérrez, José Francisco; Martínez-Pecino, Flora; Barrio-Cantalejo, Inés-María

doi:10.1016/j.pec.2009.09.027

Cited by 86 publications

(61 citation statements)

References 22 publications

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“…This further supports its use for end-of-life decision making, as both men and women are faced with these decisions, the patient's health problems are likely to be severe, and the patients tend to be in the late adult or geriatric category. Motivational interviewing is increased in effectiveness with the addition of print communication (van Keulen et al, 2010), which supports the demonstrated efficacy of print material in educating patients and families about end-of-life decisions (Tamayo-Velásquez et al, 2010). The technique has been found to be effective regardless of the professional's original discipline, and a 2-day training seminar has been found to be an effective means of learning the technique (Lundahl & Burke, 2009).…”

Section: When Meeting the Clientmentioning

confidence: 77%

The Allied Health Care Professional's Role in Assisting Medical Decision Making at the End of Life

Lambert¹

2012

Topics in Language Disorders

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As a patient approaches the end of life, he or she faces a number of very difficult medical decisions. Allied health care professionals, including speech-language pathologists (SLPs) and occupational therapists (OTs), can be instrumental in assisting their patients to make advance care plans, although their traditional job descriptions do not include this role. The allied health care professional is often in a trusted position, permitting insight into the values and beliefs of the patient and facilitating the depth of communication necessary when making difficult decisions. Professionals who work with clients at the end of life need to be aware of the many issues surrounding endof-life decision making and the preparation of advance directives for care. This article provides an overview of the complex issues the practicing clinician needs to keep in mind when assisting clients with advance care planning. This service requires that clinicians step outside their roles as rehabilitation experts, a move that is supported by professional associations. The concepts of medical decision making and informed consent are discussed in the context of decisions made in advance of illness at the end of life. The professional needs also to be aware of the legalities of advance decision making, as laws and statutes differ between states/provinces. There are overarching pieces of legislation that inform local legal and policy issues; the impact of these is briefly addressed. Various forms of documenting advance care plans, as well as their strengths and weaknesses, are discussed. Decision models are introduced as a means of guiding the clinician to provide quality care. Means of offering practical assistance to the client, such as motivational interviewing, the careful selection of appropriate educational material, and prevention of undue influence on the patient are discussed. Finally, the role of the allied health care professional in advocating for the client during the implementation is addressed. Understanding how the advance care plan should be implemented when a patient becomes incapable is essential when advocating for and protecting the rights of the patient. When a professional is prepared with the requisite understanding of all of the facets of advance care planning, he or she can become a strong ally for the patient and the family at this very important phase of life.

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Section: When Meeting the Clientmentioning

confidence: 77%

The Allied Health Care Professional's Role in Assisting Medical Decision Making at the End of Life

Lambert¹

2012

Topics in Language Disorders

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“…Th ere is some evidence about incentives for writing an AD, and many suggestions for standard requirements for professional advice and discussing the completion of an AD with the patient have been published [7][8][9][10][11]. But little is known about whether or not patients want to involve medical advisors and to what extent physicians are willing to give advice.…”

Section: Introductionmentioning

confidence: 99%

Did you seek assistance for writing your advance directive? A qualitative study

Becker¹,

Jaspers

King³

et al. 2010

Wien Klin Wochenschr

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information about the medical implications concerning patient preferences for end-of-life care seems not to be the main focus of interest when individuals write an advance directive. Autonomy and trust into notarially certified documents seem to be more important matters. If family physicians want to have a role in their patients' completing of an advance directive, they should proactively get in touch with them.

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“…One article synthesizes all of the systematic literature reviews that evaluate interventions to improve advance directive completion rates [1]. It concludes that a combination of informative materials and ongoing conversations increase the likelihood that patients complete advance directives.…”

mentioning

confidence: 99%

“…Yet, after reading these papers, one may still struggle to understand why decision-making at the end of life remains so difficult and how we find a way forward. In her paper, Tamayo-Velazquez acknowledges that even if more advance directives are completed, many question their ability to change clinical practice [1,4]. Similarly, guidelines appear to be helpful, yet most physicians today are unlikely to struggle with the ethical consequences of a DNR order in a terminally ill patient.…”

mentioning

confidence: 99%