Wishes and preferences of nursing home residents regarding Advance Care Planning – A qualitative study.

Abstract

Background: Advance Care Planning is a communication process aiming at aligning the care goals with patients’ wishes and values, ahead of the commencement of care. This is particularly important in palliative patients with a limited life expectancy. In nursing homes Advance Care Planning helps residents plan care. However, little is known about residents’ wishes and preferences regarding Advance Care Planning. Aim: This study aimed at gaining insight into Dutch nursing home residents’ wishes regarding Advance Care Planning. Method: An observational, descriptive study was conducted. Data collection consisted of semi-structured interviews with nursing home residents from March until June 2020. Analyses were performed by using the six-phase analysis framework of Braun and Clark. The Consolidated Criteria for Reporting Qualitative Research (COREQ) framework was used to guide reporting. Results: Three main themes emerged: Perception of life and health, power of family, and role and position in society. Through conversations with community dwelling octogenarians (n=16), multiple factors that influence the individual Quality of Life were identified. These factors can both have a positive, and have a diminishing effect on the individual Quality of Life. Conclusion: This study provides insight in which factors influence the daily individual Quality of Life of community dwelling octogenarians. These identified factors can give direction to how healthcare workers can target their care to improve the individual Quality of Life. Furthermore, education for health care workers should include the knowledge generated by this study to prepare them in a better way for the care of this particular group. Future research should include a more inclusive sample, gaining an even more comprehensive understanding of the factors which that influence individual Quality of Life of community dwelling octogenarians.