Advance Care Planning research study – Julie Kinley, Louisa Stone & Jo Hockley

Advance Care Planning in Nursing Care Homes: exploring the experience with residents, their family member and care home staff

There is currently a Department of Health (DH) drive to implement advance care planning (ACP) in care homes. However, very little research has been undertaken regarding either ACP or end of life decision making in the UK. The limited literature on ACP stresses that skilled communication skills are essential for those undertaking such ACP conversations. However there are no identified communication competencies recommended for nursing care home staff members.

It is of concern that ACP is being actively instigated within UK nursing care homes through DH End of Life Strategy (2008) and through the GSFCH without a evidence-based framework to underpin it. The value of undertaking ACP needs investigating alongside the impact that ACP conversations actually has on a residents care.

The aim of the study is to capture the experience of the Nursing Care Home residents, their family member and staff views following ACP conversations.

Aim and Objectives

Aim

This research study aims to determine how ACP is experienced by residents, their family and Care Home staff.

Objectives

  • To explore the care home staff experience of ACP and identify acceptable ways to initiate the concept of ACP to residents and/or their family.
  • To explore the residents preferences regarding the process of ACP.
  • To explore the family members preferences regarding the process of and their wishes for involvement with ACP.
  • To determine how often and when ACP should be undertaken.
  • To identify the perceived benefits/difficulties of ACP for residents, their family and Care Home staff.

Study Design

This study is a qualitative descriptive study design. Three local nursing care homes participated in the study.  Triad interviews were undertaken with the resident, relative (where present) and staff following the initial ACP discussion.

We included residents who were willing to participate and who could re-call the discussion. Analysis has been completed and the study is available from the International Journal of Palliative Nursing.

Posters & Presentations

Louisa Stone, Julie Kinley & Jo Hockley. Advance Care Planning in Care Homes: An exploration with staff, residents and families (PDF): HTH Conference October 2013 – Download poster (PDF)

Publications

Stone L., Kinley J. and Hockley J. Advance care planning in care homes: the experience of staff, residents and family members: International Journal of Palliative Nursing 19 (11) (2013), pages 550-557