Adapting the Serious Illness Conversation Guide for Dementia Care

Area of Science:

• Gerontology
• Palliative Care
• Neurology

Background:

• Advance care planning (ACP) is crucial for quality dementia care but often underutilized.
• Clinician discomfort and the complexities of dementia pose challenges to effective ACP.
• Existing tools like the Serious Illness Conversation Guide (SICG) are valuable but require adaptation for dementia.

Purpose of the Study:

• To adapt the validated Serious Illness Conversation Guide (SICG) for dementia care for the first time.
• To enhance the quality and utilization of advance care planning in dementia.
• To create a tool that facilitates values-based ACP conversations within the patient-caregiver-clinician triad.

Main Methods:

• A mixed-methods approach was employed for the adaptation process.
• Expert interviews were conducted to inform alterations to the SICG for dementia.
• Patient and caregiver feedback was gathered through mock interviews of the adapted SICG for dementia (SICG-D).

Main Results:

• Adaptations included topical and structural changes to the SICG to better suit dementia care and the patient-caregiver dyad.
• Thematic content analysis revealed positive impressions of the SICG-D from patients and caregivers.
• Anonymous surveys indicated 94% positive impressions and 89% endorsement for incorporating the SICG-D into dementia healthcare.

Conclusions:

• The Serious Illness Conversation Guide for Dementia (SICG-D) has been developed and adapted from the SICG.
• The SICG-D is designed to promote values-based ACP conversations and improve triadic communication in dementia care.
• This adapted guide offers a promising approach to overcoming barriers in dementia ACP and enhancing patient care.