scholarly journals Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey

2017 ◽  
Vol 35 (3) ◽  
pp. 464-472 ◽  
Author(s):  
Shoji Yokoya ◽  
Yoshiyuki Kizawa ◽  
Takami Maeno
Keyword(s):  
Palliative Care ◽  
Health Service ◽  
Advance Care Planning ◽  
Nationwide Survey ◽  
Self Report ◽  
Care Planning ◽  
Care Education ◽  
Perceived Importance ◽  
Advance Care ◽  
Eol Care

Background: The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. Methods: A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Results: Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education–providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. Conclusion: A large discrepancy was found between GHSF nurses’ practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident’s preferences concerning EOL care.

Predictors of the Willingness to Promote Advance Care Planning among Nurses in Palliative Care Settings in Yogyakarta, Indonesia

2021 ◽  
Vol 11 (3) ◽  
pp. 336-345
Author(s):  
Ike Wuri Winahyu Sari ◽  
Rizqi Wahyu Hidayati
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Pearson Correlation ◽  
Related Factor ◽  
Care Planning ◽  
Cross Sectional ◽  
Correlation Test ◽  
Care Education ◽  
Palliative Care Education ◽  
Advance Care

Background: While previous studies showed that oncology nurses were highly inclined to promote advance care planning (ACP), there is a limited study focusing on ACP that concerns the willingness to promote ACP among palliative nurses in Indonesia. This issue needs to be investigated to determine the causative factors so that interventions for nurses can be arranged to improve ACP in Indonesia.Purpose: This study aimed to identify predictors of the willingness to promote ACP among nurses in palliative care settings.Methods: This study used a descriptive-analytical design with a cross-sectional approach. A total of 150 registered nurses with at least one year of experience were purposively recruited. Data were collected using the Indonesian version of the willingness to promote ACP instrument (I-WPACP) with a possible score range of 24 to 120; the higher the score, the higher the willingness to promote ACP. The descriptive statistic, independent t-test, Pearson correlation test, Spearman rank correlation test, and multiple linear regression test were used to analyze the data.Results: The willingness to promote ACP showed a mean score of 84.73±9.36. The score indicates a high willingness to promote ACP. The experience of receiving palliative care education became a related factor as well as the most closely related factor to the willingness to promote ACP in the palliative care settings (β=0.184; p=0.028).Conclusion: The willingness to promote ACP among nurses is high and closely related to their experience of receiving education about palliative care. Education about palliative care and training on ACP needs to be developed so that nurses can discuss ACP with patients and family caregivers.

Connecting Personal Experiences of Loss and Professional Practices in Advance Care Planning and End-of-Life Care: A Survey of Providers

2018 ◽  
Vol 35 (11) ◽  
pp. 1369-1376
Author(s):  
Cara L. Wallace ◽  
Dulce M. Cruz-Oliver ◽  
Jennifer E. Ohs ◽  
Leslie Hinyard
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Advance Care Planning ◽  
Professional Practices ◽  
Care Planning ◽  
Personal Experiences ◽  
Advance Care ◽  
Hospice And Palliative Care ◽  
Eol Care

Background: Although practitioners overwhelmingly agree on the importance of advance care planning (ACP) and preparing for the end of life (EOL), the process is fraught with barriers. Objective: The goal of this research was to explore potential connections between providers’ own personal experiences and current professional practices in ACP and EOL care. Design: A cross-sectional survey design, gathering voluntary, anonymous responses from participants between August and December 2016. The survey sought information from providers in 3 distinct areas: (1) personal experiences of loss, (2) personal ACP, and (3) professional practices related to ACP and EOL care. Setting/Participants: One hundred and ninety health-care professionals (primarily physicians, nurses, and social workers) participated in the survey across a greater, Metropolitan area in the Midwest. Measurements: Questions for professional practices were subscales from the End-of-Life Professional Caregiver Survey: Patient- and Family-Centered Communication (PFCC) and Effective Care Delivery (ECD). Questions developed by the research team were evaluated by judges chosen for clinical and/or research expertise. Results: Numerous connections were found between professionals’ histories of loss, personal ACP, and professional practices. For example, both clinicians with personal experience caring for someone who is dying and clinicians who had completed their own ACP scored higher in both PFCC and ECD and were more likely to refer patients to hospice and palliative care. Conclusions: Results support educational interventions involving opportunities for reflection and completion and communication about ACP. Additionally, educational opportunities for students in health care should focus on incorporating both ACP and greater exposure to hospice and palliative care.

scholarly journals Palliative Care Education During COVID-19: The MERI Center for Education in Palliative Care at UCSF/Mt. Zion

2021 ◽  
pp. 104990912110002
Author(s):  
Michael W. Rabow ◽  
Judith Redwing Keyssar ◽  
Judith Long ◽  
Maki Aoki ◽  
Gayle Kojimoto
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Symptom Management ◽  
Care Planning ◽  
Systemic Racism ◽  
Care Education ◽  
The Core ◽  
Palliative Care Education ◽  
Global Pandemic ◽  
Advance Care

In the setting of the COVID-19 pandemic as well as the recognition of systemic racism in our institutions, the symptom management, emotional/psychological support and advance care planning at the core of palliative care—once considered “an extra layer of support” —have been revealed as instrumental to individuals, families, communities, and countries facing the threat of the global pandemic. In this article, we outline the primary palliative care education efforts of one palliative care education center (The MERI Center at UCSF/Mt Zion campus) and detail the critical adjustments necessary and opportunities found in the COVID crisis.

Demenz aus palliativmedizinischer Perspektive: warum ein krankheitsspezifisches Advance Care Planning wichtig ist

2018 ◽  
Vol 75 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Ralf J. Jox ◽  
Francesca Bosisio ◽  
Eve Rubli Truchard
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
Menschen Mit Demenz

Zusammenfassung. Die Palliative Care muss sich im Zuge des demographischen Wandels vieler Gesellschaften rund um den Globus tiefgreifend wandeln. Sie muss mehr und mehr mit der Geriatrie zusammenarbeiten und geriatrische Expertise integrieren. Eine der zentralen Herausforderungen Geriatrischer Palliative Care ist die ethisch angemessene Therapieentscheidung für Menschen, die nicht mehr urteilsfähig sind. Nachdem der bisherige Ansatz herkömmlicher Patientenverfügungen erwiesenermassen enttäuscht hat, wird aktuell, gerade auch in deutschsprachigen Ländern, das systemische Konzept des Advance Care Planning (ACP) verfolgt. In diesem Artikel wird zunächst ACP mit seinen Zielen, Elementen und Effekten vorgestellt. Sodann wird gezeigt, weshalb es für Menschen mit Demenz eines adaptierten ACP-Programms bedarf und was ein solches demenzspezifisches ACP beinhalten muss.

scholarly journals Assisted Living Administrators’ Approaches to Advance Care Planning

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 66-66
Author(s):  
Elise Abken ◽  
Alexis Bender ◽  
Ann Vandenberg ◽  
Candace Kemp ◽  
Molly Perkins
Keyword(s):  
Advance Care Planning ◽  
Assisted Living ◽  
Staff Training ◽  
Chronically Ill ◽  
External Support ◽  
Care Plan ◽  
Care Planning ◽  
Term Care ◽  
Advance Care ◽  
Eol Care

Abstract Assisted living (AL) communities are increasingly home to frail, chronically ill older adults who remain until death. State laws mandate that AL facilities request copies of any advance care planning documents residents have and make forms available upon request. Using secondary data from a larger study funded by the National Institute on Aging (R01AG047408) that focuses on end-of-life (EOL) care in AL, this project investigated barriers and facilitators to conducting advance care planning in AL. Data included in-depth interviews (of 86 minute average length) with 20 administrators from 7 facilities around the Atlanta metropolitan area and aggregate data collected from each facility regarding facility, staff, and resident characteristics. Findings from thematic analysis of qualitative data showed that key barriers to planning in AL included lack of staff training and reluctance among administrators and families to discuss advance care planning and EOL care. Important facilitators included periodic follow-up discussions of residents’ wishes, often during care plan meetings, educating families about the importance of planning, and external support for staff training and family education from agencies such as hospice and home health. Three study facilities exceeded state requirements to request and store documents by systematically encouraging residents to complete documentation. These facilities, whose administrators discuss advance care planning and residents’ EOL wishes with residents and families during regular care plan meetings, were more likely to have planning documents on file, demonstrating the potential of long-term care communities, such as AL, to successfully promote advance care planning among residents and their family members.

Communication around palliative care principles and advance care planning between oncologists, children with advancing cancer and families

2021 ◽  
Author(s):  
Erica C. Kaye ◽  
Cameka Woods ◽  
Kendall Kennedy ◽  
Srilakshmi Velrajan ◽  
Melanie Gattas ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

The Role and Activities of Board-Certified Chaplains in Advance Care Planning

2021 ◽  
pp. 104990912198999
Author(s):  
Jung Kwak ◽  
Soyeon Cho ◽  
George Handzo ◽  
Brian P. Hughes ◽  
Sami S. Hasan ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Self Report ◽  
Healthcare Team ◽  
Care Planning ◽  
Cross Sectional ◽  
Team Members ◽  
Roles And Responsibilities ◽  
Healthcare Settings ◽  
Academic Medical ◽  
Advance Care

Background: Healthcare chaplains have key roles in providing palliative support to patients and families, and they are well-suited to facilitate advance care planning (ACP). However, empirical data on the roles and responsibilities of chaplains in facilitating ACP are limited. Objectives: To examine the roles of board-certified healthcare chaplains in ACP in various healthcare settings. Methods: A cross-sectional, web-based self-report survey was conducted with 585 board-certified chaplains recruited from 3 major professional chaplains’ organizations in the U.S. The survey data included chaplains’ demographic and professional characteristics, their roles and responsibilities, and responses regarding communication and participation with other healthcare team members in facilitating ACP, including experienced barriers. Results: More participants worked in community hospital settings (42%) and academic medical centers (19.6%) than in any other setting. Over 90% viewed ACP as an important part of their work, 70% helped patients complete advance directives, and 90% helped patients discuss their preferences about end-of-life treatments. Many chaplains were not consistently included in team discussions regarding decision-making, although most chaplains reported that they could always find ways to communicate with their teams. Conclusion: Professional board-certified chaplains regularly engage in facilitating ACP discussions with patients and families in various healthcare settings. There is a need to recognize and provide systematic support for the role of chaplains in facilitating ACP conversations and to integrate chaplains into routine interdisciplinary team and family meetings.

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