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Advance care planning in residential care
1Division of Geriatric Medicine, John Hunter Hospital, Newcastle, NSW. knair@mail.newcastle.edu.au
Australian and New Zealand Journal of Medicine
|July 29, 2000
Summary
Advance care planning (ACP) and advance care directives (ACD) are rarely used in Australian residential care. Informal decision-making processes are more common, but gaps in care planning exist.
Area of Science:
- Gerontology
- Healthcare Management
- Medical Ethics
Background:
- Optimal care for the aging population necessitates advance care planning (ACP).
- International data indicate suboptimal ACP and advance care directive (ACD) use in residential care.
- Limited Australian data exist on ACP and ACD prevalence in this setting.
Purpose of the Study:
- To investigate the process of advance care planning (ACP).
- To determine the prevalence of advance care directives (ACD) in Australian residential care settings.
Main Methods:
- A cross-sectional study design was employed.
- Data were collected using questionnaires.
- The study was conducted in the Hunter region of New South Wales, Australia.
Main Results:
- Formal advance directives were found in only 0.2% of residents.
- Documented 'no-CPR' orders were present for 1.1% of residents.
- While 65% had a 'person responsible' for decisions, 10.6% lacked a clear medical decision-making process.
Conclusions:
- Formal advance directives are infrequently utilized in Australian residential care.
- Informal advance planning methods are more prevalent than formal directives.
- Further research is needed to understand current medical decision-making processes in residential care.