Goals of Care Conversations and Subsequent Advance Care Planning Outcomes for People with Dementia

被引:11
|
作者
Ma, Heather [1 ]
Kiekhofer, Rachel E. [2 ]
Hooper, Sarah M. [3 ]
Dulaney, Sarah [2 ]
Possin, Katherine L. [2 ,4 ]
Chiong, Winston [2 ]
机构
[1] Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Neurol, Memory & Aging Ctr, UCSF Weill Inst Neurosci, San Francisco, CA USA
[3] UC Hastings Coll Law, UCSF UC Consortium Law Sci & Hlth Policy, San Francisco, CA USA
[4] Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA
关键词
Advance care planning; Alzheimer's disease; dementia; patient preference; terminal care; END-OF-LIFE; NURSING-HOME RESIDENTS; FAMILY-MEMBERS; ASSOCIATION; DIRECTIVES; DELPHI; ADULTS; HEALTH; IMPACT; COST;
D O I
10.3233/JAD-210720
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Advance care planning has been shown to improve end of life decision-making for people with dementia. However, the impact of goals of care conversations between people with dementia and their caregivers has not been characterized. Objective: In this study, we evaluate the association between goals of care conversations and advance care planning outcomes. Methods: Retrospective advance care planning measures were collected via a questionnaire administered to 166 caregivers after the death of the person with dementia for whom they provided care. Results: At time of death, the majority of decedents with dementia had advance directives, health care agents, and previous goals of care conversations with their caregiver. Goals of care conversations were significantly associated with the perceived usefulness of advance directives, the perceived adherence to advance directives, and decedent dying at their desired place of death, but not with disagreements around end-of-life care. Conclusion: Our findings suggest that goals of care conversations are an important component of advance care planning. These findings support the development of interventions that facilitate such conversations between people with dementia and their caregivers.
引用
收藏
页码:1767 / 1773
页数:7
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