Discussing end of life wishes – the impact of community interventions?

Abstract

Background Many people do not discuss end of life preferences with those closest to them, although this can be beneficial to the individual and wider population. This study evaluated a community intervention to promote end of life preparation and discussion among people who are currently well. Methods A series of presentations and workshops (the intervention) were delivered to community groups and people working within health and social care. Participants were invited to complete a three-stage follow-up survey at Baseline, Post intervention and at three months' follow-up. Results Baseline questionnaires were completed by 498 individuals. Overall, 51% reported talking with close family or friends about their end of life care and 58% reported talking about what they would like to happen after their death. There was a significant positive relationship between increasing age group and having talked about end of life wishes. The majority of participants were already comfortable in talking about end of life (overall mean score 8.28/10). Post intervention, 73% stated that they planned to take action including 61% who planned a specific conversation and 55% who planned another action. At follow-up 64% reported that they had taken some action due to the intervention, including 43% who had talked about their own end of life preferences and 39% who had taken some other action. Conclusions Well-designed community-based interventions can be successful in prompting people to consider and discuss their end of life preferences. Electronic supplementary material The online version of this article (10.1186/s12904-019-0407-8) contains supplementary material, which is available to authorized users.

Information meetings on end-of-life care for older people by the general practitioner to stimulate advance care planning: a pre-post evaluation study

“…There are few studies on information meetings [17,23], and we did not find previous studies of end-of-life information meetings initiated by GPs. The information meetings were held by GPs from four different group practices.…”

“…The meetings seem to be a time efficient way to stimulate ACP conversations with the GP and others. A recent study on two public health interventions (‘Awareness-Raising’ presentations and ‘How to’ workshops) also yielded positive results with regard to stimulating discussions [ 17 ]. The GPs did not receive a remuneration for organising these meetings.…”

Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care: A Study from Sweden

“… Zwakman and colleagues (2018) found that participants with life-limiting illnesses suggested that ACP should take place sooner rather than later, to be experienced as less confrontational and therefore easier to accept. Recent studies have pointed to benefits in designing early, community-based interventions targeting people prior to diagnosis with life-limiting illnesses ( Abba, Lloyd-Williams, & Horton, 2019 ; Banner et al, 2019 ; Costello, Hinderer, Lee, & Chike-Udegha, 2015 ).…”

Predictors of End of Life Discussions Among Minority Older Women Living With HIV Infection

“…14 Certain predictors to EOL discussions have been identified in the literature such as educational level, 20 living with a partner or other caregiver, 21 religiosity, [22][23][24][25][26] pain intensity, 21,27,28 older age, 29 and community activities. 29 However, limited research exists about the predictors for EOL discussions of minority older PLWH, particularly Black and Hispanic women. 30 Determining significant predictors may help guide future efforts to improve EOL discussions among these women.…”