Factors Associated with Initiation of Advance Care Planning in Dementia: A Systematic Review

Abstract

Professional caregivers may initiate ACP early if strategies carefully consider timing and family and patient receptiveness or reluctance, and are family and patient-centered. Interventions should address the complexity of interrelated system and personal factors affecting initiation of ACP.

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

“…The diversity among physicians might represent the same variability in readiness to plan ahead as found with families and patients with dementia (4,5,7). In contrast, 90% of the EAPC expert panel agreed with the recommendation "Anticipating progression of the disease, ACP is proactive.…”

“…There are many possible barriers to initiating ACP, including among professionals, such as not taking the initiative (7).…”

Advance care planning for nursing home residents with dementia: Influence of ‘we DECide’ on policy and practice

“…This includes not only the clinical staff but also the management [6,[17][18][19][20][21]. That is why staff from both the management and clinical level were involved in 'we DECide'.…”

“…In most cases, however, preferences for end-of-life care are not addressed in the GP practice [5]. Another important occasion to discuss end-of-life planning is at the moment of admission to a nursing home [6,7].…”

Forberedende samtaler i norske sykehjem

“…Sharp og medarbeidere fant at 60 -80 % av de gamle selv ønsket å diskutere disse spørsmålene (12). van der Steen og medarbeidere så på hvilke forhold som fremmer denne type samtaler hos pasienter med demens og deres på-rørende og konkluderte med at helsepersonell burde ta initiativet (13). Man må vaere sensitiv når det gjelder valg av tidspunkt og åpen for respons fra pasienter og pårørende.…”