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Experiences of Older Adults with Frailty Not Completing an Advance Directive: A Qualitative Study of ACP Conversations
International Journal of Environmental Research and Public Health ; 19(9):5358, 2022.
Article in English | ProQuest Central | ID: covidwho-1837912
ABSTRACT
Advance care planning (ACP) facilitates individuals to proactively make decisions on their end-of-life care when they are mentally competent. It is highly relevant to older adults with frailty because they are more vulnerable to cognitive impairment, disabilities, and death. Despite devoting effort to promoting ACP among them, ACP and advance directive completion rates remain low. This study aims to explore the experiences among frail older adults who did not complete an advance directive after an ACP conversation. We conducted a thematic analysis of audiotaped nurse-facilitated ACP conversations with frail older adults and their family members. We purposively selected ACP conversations from 22 frail older adults in the intervention group from a randomized controlled trial in Hong Kong who had ACP conversation with a nurse, but did not complete an advance directive upon completing the intervention. Three themes were identified “Refraining from discussing end-of-life care”, “Remaining in the here and now”, and “Relinquishing responsibility over end-of-life care decision-making”. Participation in ACP conversations among frail older adults and their family members might improve if current care plans are integrated so as to increase patientsmotivation and support are provided to family members in their role as surrogate decision-makers.
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Collection: Databases of international organizations Database: ProQuest Central Type of study: Qualitative research Language: English Journal: International Journal of Environmental Research and Public Health Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: ProQuest Central Type of study: Qualitative research Language: English Journal: International Journal of Environmental Research and Public Health Year: 2022 Document Type: Article