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Permanent link (DOI): https://doi.org/10.7939/R3CN6Z301

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Advance Directives in the Context of Uncertain Prognosis for Residents of Nursing Homes. Open Access

Descriptions

Author or creator
Williams, B.E.C.
Wilson, D.M.
Keating, N.
Additional contributors
Subject/Keyword
advance care planning
advance directives
nursing homes
palliative care
Type of item
Journal Article (Published)
Language
English
Place
Time
Description
This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directive within 3 months of death, most did not have a palliative designation or directive until a few days before they died. Each facility’s written Progress Notes revealed staff members usually sought additional confirmation of care preferences from residents’ substitute decision-makers within a few days of the death. It was thus common for advance directives to change from a more interventionist approach to the least interventionist approach near death. This change indicates that the meaning and significance of advance care planning and resulting advance directives must be considered in light of the processes and temporal factors involved in their completion and use within this distinct population. The relational nature of advance care planning and concern about ageism as a factor for withholding or withdrawing life support for LTC residents are considered as possible explanatory factors. These findings and their implications are described in relation to end-of-life care policies and practices in LTC facilities.
Date created
2014
DOI
doi:10.7939/R3CN6Z301
License information
Creative Commons Attribution-Non-Commercial 3.0 Unported
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Citation for previous publication
Williams, B.E.C., Wilson, D.M., & Keating, N. (2014). Advance Directives in the Context of Uncertain Prognosis for Residents of Nursing Homes. Open Journal of Nursing, 4(04), 321.
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File title: Advance Directives in the Context of Uncertain Prognosis for Residents of Nursing Homes
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