Premium
Advance care planning for institutionalised older people: an integrative review of the literature
Author(s) -
Séchaud Laurence,
Goulet Céline,
Morin Diane,
Mazzocato Claudia
Publication year - 2014
Publication title -
international journal of older people nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.707
H-Index - 29
eISSN - 1748-3743
pISSN - 1748-3735
DOI - 10.1111/opn.12033
Subject(s) - advance care planning , identification (biology) , context (archaeology) , psychology , quality (philosophy) , nursing , quality of life (healthcare) , empirical research , knowledge management , management science , medicine , computer science , palliative care , engineering , paleontology , philosophy , botany , epistemology , biology
Background This integrative review of the literature describes the evolution in knowledge and the paradigm shift that is necessary to switch from advance directives to advance care planning. Aims and objectives It presents an analysis of concepts, trends, models and experiments that enables identification of the best treatment strategies, particularly for older people living in nursing homes. Design Based on 23 articles published between 1999 and 2012, this review distinguishes theoretical from empirical research and presents a classification of studies based on their methodological robustness (descriptive, qualitative, associative or experimental). Results It thus provides nursing professionals with evidence‐based information in the form of a synthetic vision and conceptual framework to support the development of innovative care practices in the end‐of‐life context. While theoretical work places particular emphasis on the impact of changes in practice on the quality of care received by residents, empirical research highlights the importance of communication between the different persons involved about care preferences at the end of life and the need for agreement between them. Conclusions The concept of quality of life and the dimensions and factors that compose it form the basis of Advance care planning (ACP) and enable the identification of the similarities and differences between various actors. They inform professionals of the need to ease off the biomedical approach to consider the attributes prioritised by those concerned, whether patients or families, so as to improve the quality of care at the end of life. Implications for practice It is particularly recommended that all professionals involved take into account key stakeholders' expectations concerning what is essential at the end of life, to enable enhanced communication and decision‐making when faced with this difficult subject.