P231 Overview of an Advance Care Planning (ACP) Model for Care Home Residents Living with Dementia

Brazil, Kevin and Carter, Gillian and McLaughlin, Dorry and Kernohan, George and Hudson, Peter and Clarke, Mike and Froggatt, Katherine and Passmore, Peter and Cardwell, Chris (2016) P231 Overview of an Advance Care Planning (ACP) Model for Care Home Residents Living with Dementia. Journal of Pain and Symptom Management, 52 (6). e126. ISSN 0885-3924

Abstract

Objectives To report on the feasibility and acceptability of an ACP model for individuals living with dementia in a sample of care homes in the United Kingdom. Method As part of a cluster randomised controlled trial including 25 Care Homes, carers of residents living with dementia in 13 of these homes were exposed to an ACP intervention. This comprised of five elements: an ACP facilitator; family education; a family meeting with a follow-up; documentation of ACP decisions; and, orientation for GPs and care home staff about the intervention. One feature of the evaluation included a detailed documentation on the delivery of the intervention, supplemented with stakeholder interviews to assess its feasibility and acceptability. The ACP Facilitator maintained both a narrative journal and a log of activities associated with tasks during the delivery of the intervention. A qualitative interview was held with the ACP Facilitator to discuss their perceptions of the implementation, challenges and benefits of the ACP model. Participating care home managers and family carers also completed a qualitative interview to determine whether they perceived such a model helped or hindered care. Results On average administration of the ACP intervention took two hours to complete on an individual family basis. Care home managers (five from each study arm) and family carers in combination with the findings from the ACP facilitator highlighted the acceptability of the intervention, the importance of such a role to be fulfilled within the care home environment was stressed, however time and staff restraints were noted as key barriers. Nonetheless, the interest and motivation of staff to make such a role possible was clear. Conclusions This presentation identifies the feasibility and perceived acceptability of an ACP intervention suitable for dementia residents in care homes in the UK.