Health care professionals' perspectives of advance care planning for people with dementia living in long-term care settings: A narrative review of the literature

Dementia (London). 2017 May;16(4):486-512. doi: 10.1177/1471301215604997. Epub 2015 Sep 16.

Abstract

This paper provides an overview of the evidence on the perspective of health care professionals (HCPs) in relation to advance care planning (ACP) for people with dementia, residing in long-term care settings. A narrative approach was adopted to provide a comprehensive synthesis of previously published literature in the area. A systematic literature search identified 14 papers for inclusion. Following review of the studies four themes were identified for discussion; Early integration and planning for palliative care in dementia; HCPs ethical and moral concerns regarding ACP; Communication challenges when interacting with the person with dementia and their families and HCPs need for education and training. Despite evidence, that HCPs recognise the potential benefits of ACP, they struggle with its implementation in this setting. Greater understanding of dementia and the concept of ACP is required to improve consistency in practice. Synthesising the existing evidence will allow for further understanding of the key issues, potentially resulting in improved implementation in practice.

Keywords: advance care planning; end-of-life decision making; health care professionals; nursing home.

MeSH terms

  • Advance Care Planning*
  • Advance Directives
  • Attitude of Health Personnel*
  • Dementia / psychology*
  • Health Personnel / psychology
  • Humans
  • Long-Term Care*
  • Palliative Care*