Advance patient directives prepared for end-of-life care in clinical deterioration and cardiopulmonary arrest in residential aged care facilities / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : This study examines the feasibility of providing end-of-life care at a residential aged care facility using advance patient directives from the perspective of the non-medical facility staff.<br><b>Methods</b> : Efforts were made by the facility staff to obtain advanced patient directives (APD) from 240 residents. Compliance by staff and residents in documentation of APDs for cardiopulmonary arrest (CPA) was examined.<br><b>Results</b> : APDs were obtained from 204 residents (85%) and all responded to questions regarding end-of-life care in the facility without resuscitation or emergency transfer, indicating their autonomous wishes. Of the 204 respondents, 196 indicated preferences for both resuscitation and emergency transfer, 62% of which indicated preference for no resuscitation and no emergency transfer. No statistical differences were noted based on age, sex, or diagnoses. Fourteen residents died eight (58%) of whom received end-of-life care in the facility.<br><b>Conclusion</b> : Non-medical staff can effectively document resident's wishes using APDs addressing clinical deterioration and CPA.