Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia

AimTo evaluate the effects of we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. BackgroundAdvance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). DesignThis quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. MethodsWe DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the IFC-SDM Questionnaire' assesses participants' views on I, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). DiscussionThe study hypothesis is that we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers.