Background: Evidence indicates that whilst older people may wish to plan ahead, often theyare not given the opportunity to do so. Advance Care Planning is considered as key processthat enables planning ahead to be achieved. Demographics indicate that there are anincreasing no of people with dementia residing in nursing home settings. Staff in suchsettings have an important role in assisting with ACP, yet there is a deficit in understandingthe issues from their perspective.Aim: To examine the HCPs’ perspectives of ACP for people with dementia in the LTCS.Methods: A sequential explanatory mixed methods design incorporating 2 interrelatedphases.Phase 1: Systematic narrative review of empirical studies published between 2002-2014yielded 14 relevant articles which focused on HCP’s perspective of ACP for people withdementia in this setting.Phase 2: A cross sectional survey to all nursing home managers (n=269) in a region in the UK.Results: Within the literature there is considerable variation in HCP’s perspectives of ACP.These were grouped under 4 key themes: Early integration and planning for palliative care indementia; Ethical and Moral Factors; Communication and Education, Training andKnowledge. The validity of this evidence will be further refined through quantitativeexploring involving registered nursing home manager’s perspectives on ACP using astructured tool focusing on three domains; understanding, attitudes and practice,underpinned by the Theory of Planned Behaviour.Conclusions: Despite evidence, albeit limited, that HCP’s recognise the potential benefits ofACP, there is continued reluctance to engage. The inequality in terms of access to palliativecare is central to this, with increased integration at an early stage vital. Greaterunderstanding of HCP’s perspectives on ACP in this complex setting will contribute to thedevelopment of appropriate educational support and improved care for people withdementia approaching end of life.
|Journal||European Journal of Palliative Care|
|Publication status||Published - May 2015|
- health care professionals
- advanced care planning
- long term care setting