ACP FOR HEALTHY OLDER ADULTS: STRATEGIES AND TOOLS FOR A PUBLIC HEALTH APPROACH. Issue 2 (1st June 2013)

• Record Type: Journal Article
• Authors: Street, A; Threlkeld, G; Blackford, J; Bidstrup, B; Downing, J
• Is Part Of: BMJ supportive & palliative care. Volume 3:Issue 2(2013)
• Page Start: 270
• Page End: 271
• Publication Date: 2013-06-01
• Subjects: Palliative treatment -- Periodicals; Terminal care -- Periodicals; 616.029
• DOI: 10.1136/bmjspcare-2013-000491.117
• Languages: English
• ISSNs: 2045-435X

Abstract

Abstract : Background: Engaging older community-dwelling healthy adults in ACP discussions is an international public health challenge that requires social strategies to ensure uptake of ACP in non clinical settings. Aim: The entrust-u study developed and tested an approach to ACP with older adults in rural communities that addressed guiding values, appointment of a decision maker, content of ACP discussions for healthy adults, documenting conversations and informing GPs. Methods: Collaborative action research was conducted over three cycles of planning, action, evaluation and reflection to develop and test the entrust-u process. We tested the use of life review, ecomaps and the 'Go Wish' game as strategies through interviews, focus groups and analysis of life reviews with 25 older people, 7 palliative care volunteers and four co-ordinators. Results: 25/25 older people completed a Future Wishes document, 18/25 appointed a substitute decision maker and 14/16 requested a follow up letter to their GP. All volunteers completed or re-visited their own MEPOAs and Future Wishes documents. We developed and refined a volunteer training module to be included in the Palliative Care Volunteers Kit that included a Train the Trainer process and a manual for coordinators of volunteers. Discussion: Discussions on preparation for death require a range of strategies and tools. We worked collaboratively with rural community palliative care services to initiate discussions on facing death and ACP through a three-stage flexible structured interview process. Conclusion: Entrust-u used a variety of tools and strategies to successfully involve palliative care volunteers in conducting ACP discussions with older people.