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Advance care planning participation by people with dementia: a cross-sectional survey and medical record audit

Objectives

To describe among individuals with dementia: (1) self-reported awareness of, and engagement in, advance care planning; (2) presence of advance care planning documentation in the health record and (3) concordance between self-reported completion of advance care planning and presence of documentation in the health record.

Methods

An Australian prospective multicentre audit and cross-sectional survey. Individuals diagnosed with dementia who were able to speak English and were judged by a healthcare provider as having decision-making capacity were recruited from self-selected hospitals, residential aged care facilities and general practices across Australia.

Results

Fifty-two people with dementia completed surveys and were included. Overall, 59.6% of participants had heard about advance care planning and 55.8% had discussed advance care planning with someone, most often a family member (48.1%). While 38.5% of participants had appointed a medical substitute decision maker, only 26.9% reported that they had written down their values and preferences for future care. Concordance between self-reported completion of advance care planning and presence of documentation in the health record was low (56.8%, =0.139; 57.7%, =0.053).

Conclusion

Effective models that promote discussion, documentation and accessible storage of advance care planning documents for people with dementia are needed.

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Posted in: Open Access Journal Articles on 03/27/2021 | Link to this post on IFP |
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