Tamara Sussman1, Sharon Kaasalainen2, Rennie Bimman3, Harveer Punia2, Nathaniel Edsell3, Jess Sussman4. 1. McGill University School of Social Work, 3506 Rue University #300, Montréal, QC, H3A 2A7, Canada. tamara.sussman@mcgill.ca. 2. Health Sciences Centre, McMaster University School of Nursing, 2J20, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. 3. McGill University School of Social Work, 3506 Rue University #300, Montréal, QC, H3A 2A7, Canada. 4. University of Toronto Faculty of Medicine, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
Abstract
OBJECTIVES: Despite known benefits, advance care planning (ACP) is rarely a component of usual practice in long-term care (LTC). A series of tools and workbooks have been developed to support ACP uptake amongst the generable population. Yet, their potential for improving ACP uptake in LTC has yet to be examined. This study explored if available ACP tools are acceptable for use in LTC by (a) eliciting staff views on the content and format that would support ACP tool usability in LTC (b) examining if publicly available ACP tools include content identified as relevant by LTC home staff. Ultimately this study aimed to identify the potential for existing ACP tools to improve ACP engagement in LTC. METHODS: A combination of focus group deliberations with LTC home staff (N = 32) and content analysis of publicly available ACP tools (N = 32) were used to meet the study aims. RESULTS: Focus group deliberations suggested that publicly available ACP tools may be acceptable for use in LTC if the tools include psychosocial elements and paper-based versions exist. Content analysis of available paper-based tools revealed that only a handful of ACP tools (32/611, 5%) include psychosocial content, with most encouraging psychosocially-oriented reflections (30/32, 84%), and far fewer providing direction around other elements of ACP such as communicating psychosocial preferences (14/32, 44%) or transforming preferences into a documented plan (7/32, 22%). CONCLUSIONS: ACP tools that include psychosocial content may improve ACP uptake in LTC because they elicit future care issues considered pertinent and can be supported by a range of clinical and non-clinical staff. To increase usability and engagement ACP tools may require infusion of scenarios pertinent to frail older persons, and a better balance between psychosocial content that elicits reflections and psychosocial content that supports communication.
OBJECTIVES: Despite known benefits, advance care planning (ACP) is rarely a component of usual practice in long-term care (LTC). A series of tools and workbooks have been developed to support ACP uptake amongst the generable population. Yet, their potential for improving ACP uptake in LTC has yet to be examined. This study explored if available ACP tools are acceptable for use in LTC by (a) eliciting staff views on the content and format that would support ACP tool usability in LTC (b) examining if publicly available ACP tools include content identified as relevant by LTC home staff. Ultimately this study aimed to identify the potential for existing ACP tools to improve ACP engagement in LTC. METHODS: A combination of focus group deliberations with LTC home staff (N = 32) and content analysis of publicly available ACP tools (N = 32) were used to meet the study aims. RESULTS: Focus group deliberations suggested that publicly available ACP tools may be acceptable for use in LTC if the tools include psychosocial elements and paper-based versions exist. Content analysis of available paper-based tools revealed that only a handful of ACP tools (32/611, 5%) include psychosocial content, with most encouraging psychosocially-oriented reflections (30/32, 84%), and far fewer providing direction around other elements of ACP such as communicating psychosocial preferences (14/32, 44%) or transforming preferences into a documented plan (7/32, 22%). CONCLUSIONS: ACP tools that include psychosocial content may improve ACP uptake in LTC because they elicit future care issues considered pertinent and can be supported by a range of clinical and non-clinical staff. To increase usability and engagement ACP tools may require infusion of scenarios pertinent to frail older persons, and a better balance between psychosocial content that elicits reflections and psychosocial content that supports communication.
Entities:
Keywords:
Advance directive; Assisted living; Death and dying; End-of-life communication; Nursing homes; Palliative care
Authors: Judith A C Rietjens; Rebecca L Sudore; Michael Connolly; Johannes J van Delden; Margaret A Drickamer; Mirjam Droger; Agnes van der Heide; Daren K Heyland; Dirk Houttekier; Daisy J A Janssen; Luciano Orsi; Sheila Payne; Jane Seymour; Ralf J Jox; Ida J Korfage Journal: Lancet Oncol Date: 2017-09 Impact factor: 41.316
Authors: Sharon Kaasalainen; Tamara Sussman; Maria Nicula; Jack Lawrence; Genevieve Thompson; Lynn McCleary; Abigail Wickson-Griffiths; John J You Journal: SAGE Open Nurs Date: 2021-11-01