Family Caregivers' Characterization of Conversations Following an ACP Event

Area of Science:

• Gerontology
• Palliative Care
• Communication Studies

Background:

• Advance care planning (ACP) is known to benefit patients and families.
• Limited understanding exists regarding the impact of ACP events on communication about end-of-life treatment wishes between patients and family caregivers.

Purpose of the Study:

• To characterize post-ACP conversations regarding medical wishes between seriously ill patients and their family caregivers.

Main Methods:

• A randomized controlled trial involved dyads of seriously ill patients and family caregivers who engaged in ACP and created an advance directive.
• Semistructured interviews with family caregivers were conducted 4–6 weeks post-ACP to explore subsequent communications about medical wishes.
• Reasons and barriers for lack of post-ACP conversations were investigated.

Main Results:

• The majority of dyads (69.7%) had 2–3 brief conversations (3–5 minutes) post-ACP.
• These conversations primarily focused on general patient wishes regarding quality of life and specific medical treatments.
• Common barriers to conversation included discomfort with the topic (22.8%) and prior discussions (28.1%).

Conclusions:

• ACP events stimulate conversations about end-of-life quality of life, general wishes, and specific medical preferences.
• Identified barriers to post-ACP communication mirror general ACP barriers, indicating a need for focused interventions.
• Addressing these barriers before and after ACP may enhance patient-caregiver communication regarding end-of-life wishes.