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    Development and evaluation of an aged care specific Advance Care Plan.

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    Author
    Silvester, W; Parslow, RA; Lewis, VJ; Fullam, RS; Sjanta, R; Jackson, L; White, V; Hudson, R
    Date
    2013-06
    Source Title
    BMJ Supportive and Palliative Care
    Publisher
    BMJ
    University of Melbourne Author/s
    Silvester, William; Hudson, Rosalie
    Affiliation
    Nursing
    Surgery (Austin & Northern Health)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Silvester, W., Parslow, R. A., Lewis, V. J., Fullam, R. S., Sjanta, R., Jackson, L., White, V. & Hudson, R. (2013). Development and evaluation of an aged care specific Advance Care Plan.. BMJ Support Palliat Care, 3 (2), pp.188-195. https://doi.org/10.1136/bmjspcare-2012-000392.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/264972
    DOI
    10.1136/bmjspcare-2012-000392
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632978
    Abstract
    OBJECTIVES: To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. DESIGN: An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. PARTICIPANTS AND SETTING: 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. RESULTS: Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. CONCLUSIONS: Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.

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