Impact of a community health conversation upon advance care planning attitudes and preparation intentions

Gerontol Geriatr Educ. 2021 Jan-Mar;42(1):82-95. doi: 10.1080/02701960.2020.1739670. Epub 2020 Mar 29.

Abstract

Background: Advance care planning conversations and preparations do not occur as frequently as they should. Framing advance care planning as a health behavior and an opportunity for community engagement can help improve community-dwellers' intentions to have discussions and preparations regarding facing serious illness, death and dying.Methods: A multi-setting confidential pre/post paper survey assessing advance care planning discussions and preparation intentions was given to community-dwelling citizens residing in the New York metropolitan area. Survey items were adapted from a previous end of life survey to include questions on chronic illnesses, important conversations, comfort levels and concerns about end of life. The intervention was a 1-hour presentation on advance care planning (importance, laws, effective communication and audience questions)Results: Our study found significant interest in discussing advanced care planning across age groups. There were significant changes for participant intentions regarding: having conversations with loved ones, a health care proxy or similar document and none; as well as differences in participant intentions for discussions with caregiver, family, friends, primary physician and no-one.Conclusion: Educating individuals on the importance of advance care planning may be effective in changing community dwellers' intentions to start the conversation and put advanced care planning measures in place.Abbreviations: ACP: Advance Care Planning; CHAT: Conversations Health and Treatments; EoL: End of Life; HCP: Health Care Proxy; MOLST: Medical Orders for Life-Sustaining Treatments; PCP: Primary Care Physician.

Keywords: End-of-life care; advanced care planning; community-based approach; health care proxy; hospice.

MeSH terms

  • Advance Care Planning*
  • Aged
  • Attitude to Health
  • Community Health Services / methods
  • Female
  • Geriatrics* / education
  • Geriatrics* / ethics
  • Geriatrics* / methods
  • Humans
  • Independent Living / psychology
  • Information Literacy
  • Male
  • Public Health / methods
  • Social Perception
  • Surveys and Questionnaires
  • Terminal Care / psychology