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Oral Health Assessment by Lay Personnel for Older Adults
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Advance care planning in the elderly.

Hillary D Lum1, Rebecca L Sudore2, David B Bekelman3

  • 1Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, B-179, Aurora, CO 80045, USA; Department of Medicine, VA Eastern Colorado Healthcare System, 1055 Clermont Street, Denver, CO 80220, USA.

The Medical Clinics of North America
|February 22, 2015
PubMed
Summary

Advance care planning (ACP) helps older adults document medical wishes. Integrating ACP into primary care involves communication and documentation for better healthcare decisions.

Keywords:
Advance care planningAdvance directivesCommunicationPatient-doctor relationshipSurrogate decision maker

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Area of Science:

  • Geriatric Medicine
  • Healthcare Policy
  • Medical Ethics

Background:

  • Advance care planning (ACP) is crucial for elderly healthcare decision-making.
  • Key ACP components include surrogate selection, values identification, and communication.
  • ACP often requires multiple, brief discussions over time.

Purpose of the Study:

  • To outline benefits and barriers of ACP in primary care settings.
  • To provide practical strategies for integrating ACP into primary care for older adults.
  • To highlight opportunities for multidisciplinary teams in ACP delivery.

Main Methods:

  • Review of common benefits and barriers to ACP in primary care.
  • Description of practical approaches for integrating ACP components.
  • Identification of roles for multidisciplinary teams in brief clinic visits.

Main Results:

  • Identified key components of ACP for the elderly.
  • Outlined common facilitators and challenges to ACP implementation.
  • Proposed methods for incorporating ACP into routine primary care.

Conclusions:

  • Effective ACP in primary care requires addressing benefits and barriers.
  • Multidisciplinary teams can facilitate ACP integration into brief patient encounters.
  • Translating patient values into medical orders is a critical outcome of ACP.