The Impact of Prior Advance Care Planning Documentation on End-of-Life Care Provision in Long-Term Care

Authors

  • Henry Y.H. Siu McMaster University http://orcid.org/0000-0002-1593-6827
  • Dawn Elston McMaster University
  • Neha Arora McMaster University
  • Amie Vahrmeyer Extendicare Assist
  • Sharon Kaasalainen McMaster University
  • Paula Chidwick William Osler Health System
  • Sayem Borhan McMaster University
  • Michelle Howard McMaster University
  • Daren K. Heyland Queen's University

DOI:

https://doi.org/10.5770/cgj.23.386

Keywords:

Long-term care, Advance care planning, Elderly, Substitute decision-maker

Abstract

Background

The impact of prior advance care planning (ACP) documentation on substitute decision-makers’ (SDMs) knowledge of values for end-of-life (EOL) care, and its correlation with SDM satisfaction with EOL care provision, have not been assessed in long-term care (LTC).

Methods

A cross-sectional survey of 2,595 SDMs from 27 LTC homes assessed: 1) knowledge of pre-existing ACP documentation and values for EOL care, and 2) the importance and satisfaction of EOL care provision in LTC. Knowledge of values for EOL care was compared to administrative documentation. Importance and satisfaction were plotted on a performance-importance grid. Multiple linear regression assessed whether knowledge of pre-existing ACP documentation correlated with satisfaction.

Results

The response rate was 25% (658/2,595); 69% of LTC residents had pre-existing ACP documentation. Discordance was noted between SDMs’ knowledge of values for EOL care and administrative documentation. Pre-existing knowledge of ACP documentation was not correlated with EOL care provision satisfaction. Priority areas for increasing satisfaction include illness management, SDM communication, and relationships with LTC clinicians.

Conclusions

The discordance between SDMs’ knowledge of values for EOL care and formal documentation needs to be addressed. Although pre-existing ACP documentation does not impact satisfaction, EOL care provision could be improved by targeting illness management, SDM communication, and relationships with LTC clinicians.

Downloads

Download data is not yet available.

Downloads

Published

2020-03-05

How to Cite

1.
Siu HY, Elston D, Arora N, Vahrmeyer A, Kaasalainen S, Chidwick P, Borhan S, Howard M, Heyland DK. The Impact of Prior Advance Care Planning Documentation on End-of-Life Care Provision in Long-Term Care. Can Geri J [Internet]. 2020 Mar. 5 [cited 2021 Oct. 26];23(2):172-83. Available from: https://cgjonline.ca/index.php/cgj/article/view/386

Issue

Section

Original Research