Understanding how advance care planning is approached in the residential aged care setting: A continuum model of practice as an explanatory device |
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| Authors: | Christopher Shanley Elizabeth Whitmore Angela Khoo Colleen Cartwright Amanda Walker Robert G Cumming |
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| Affiliation: | 1. Aged Care Research Unit, Liverpool Hospital, University of New South Wales, Sydney, New South Wales, Australia;2. Aged Care Research Unit, Liverpool Hospital, Sydney, New South Wales, Australia;3. Aged Services Learning and Research Centre, Southern Cross University, Sydney, New South Wales, Australia;4. Medical Director of Palliative Care, Sydney South West Area Health Service, Sydney, New South Wales, Australia;5. Centre for Education and Research on Ageing, University of Sydney, Sydney, New South Wales, Australia |
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| Abstract: | Objective: To gain an understanding of how advance care planning (ACP) is understood and approached by managers of residential aged care facilities. Methods: Qualitative interviews with managers from 41 residential aged care facilities from South Western Sydney, Australia. Content and thematic analysis of interview transcripts. Results: The majority of facilities do not have a systematic approach to ACP, but tend to initiate discussions about end‐of‐life treatments late in a resident's illness. There are varying degrees to which these discussions are used in ongoing care planning or made explicit if the resident is transferred to hospital. A number of factors are identified that support the implementation of ACP. Conclusion: A continuum model of practice is proposed that describes four broad approaches to practice under the domains of initiation, scope, follow‐up and documentation of ACP as well as the organisational leadership adopted around ACP. |
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| Keywords: | advance care planning end‐of‐life care nursing home residential aged care |
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