Purpose: Provide advanced practice nurses (APNs) with tools and guidance on spiritual assessment for advance care planning(ACP); to review the literature on the connectedness between spiritual assessment and ACP; and to discuss implications for the APN in application of these concepts with a case study. Data sources: Selected research and clinical articles. Conclusions: There is a disconnect between what patients have expressed as their wishes regarding end‐of‐life care (EOLC) and what occurs. Spiritual beliefs and values impact patients' and families' decisions regarding EOLC, but if not discussed in advance, most wishes, especially dying at home, do not occur. Implications for practice: Incorporating spiritual assessment in a holistic assessment, it is possible to assist patients and families prior to crisis in sorting out patients' wishes with respect to EOLC during clinic visits. With the use of a simple mnemonic to guide spiritual assessment, the APN can bridge the gap between what the patient wants and what care is received at end of life.

The AIDS epidemic has thus far cre¬ ated obvious medical and social crises in urban areas. The impact of this epidemic is just beginning to reach rural areas and small towns. Persons with AIDS (PWAs) are living longer while still requiring treatment. The trend for many PWAs is to "return home" to die. With more cases of AIDS being diagnosed, one can conclude that the number of PWAs in rural and small town areas is sure to increase. These rural communities need to ready themselves to respond to the needs of patients and the need for the communi¬ ty to cope to avoid a crisis.The problem is that because many small town rural areas have not been faced with large numbers of PWAs, the community has not had the opportunity nor the need to develop and utilize resources to deal with PWAs or commu¬ nity concerns about AIDS. AIDS is a new and growing problem for these areas. Rural communities are currently faced with adapting current resources and devising new resources to cope with the community problems precipitated by the growing numbers of PWAs. Resources need to be developed to provide compre¬ hensive, cost-effective care to PWAs and identify and meet the educational needs of the community. These resources would enable communities to cope. This project was born from the first¬ hand realization of the problems of the rural community in dealing with the increase of PWAs. The authors had the opportunity to work with a local AIDS Task Force which identified community resources currently available to PWAs.The Task Force decided that the first step in developing adequate resources was to assess currently available health care and community resources that could be help¬ ful to PWAs. The purpose of the article is to share the method we used to systemati¬ cally assess a rural community for services that could benefit PWAs and make recom¬ mendations for development and usage of these resources. This assessment revealed service and educational strengths and weaknesses in the community. Targeted GroupsThe community involved in this study had an AIDS task force developed through the social services department of the community hospital. Members of this task force included representatives of local professional organizations, com¬ munity service organizations, and nurs¬ ing faculty from the local college. The authors became involved in the project when members of the AIDS task force presented the need for an assessment of available services to the community nursing class.Since the number of reported AIDS cases in this county was still small, resources were being assessed before the community became significantly stressed by AIDS. To assess the availability of pro¬ fessional services to PWAs, questionnaires were mailed to local physicians, dentists, and funeral directors (see Figs. 1, 2,3). The questionnaires focused on the profession¬ als' willingness to extend their services to PWAs. A cover letter explained our pur¬ pose and ensured confidentiality. PhysiciansThe results of the questionnaires are summarized as follows. Of 48 questio...