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Four timing patterns of initiation of advance care planning discussions as practiced by home visiting nurses: A
Mitsuko Ushikubo1, Maho Ishikawa2,3
1Gunma University Graduate School of Health Sciences Maebashi Japan.
Background:
The purpose of this study was to explore the actual timing of the initiation of advance care planning (ACP) discussions by experienced visiting nurses for older homebound patients.
Methods:
Semi-structured interviews were conducted with 12 home visit nurses, followed by a qualitative, inductive analysis.
Results:
Four ACP initiation timing patterns were extracted.
Conclusions:
Home visit nurses used the following timing patterns differently depending on each patient's situation: "Starting when visiting nurses get to know the patients," "Waiting for a change in the patient's medical condition," "Waiting to begin ACP discussions until the patient and nurse are emotionally ready," and "Starting ACP discussions in a proactive, but non-shocking manner."
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