Anticipating old age: towards a practical model of Advance Care Planning (WC2014-014)

Background

Starting date: 01/04/2014

The concept of Advance Care Planning (ACP) evolved from experienced limitations of advance directives and is currently viewed as a central component of high-quality palliative care. ACP is a specific form of preventive medicine, aimed to avoid burdensome medical interventions at the end of life and to help assure that health care decisions in the final years of life are consistent with patient preferences.  Specifically, ACP is seen as a crucial element of pro-active medical care for older patients with chronic progressive and disabling illness. However, although advocated widely, the concept of ACP still awaits operationalization and implementation in the Dutch health care system and until now, when older persons are admitted to a nursing home, ACP has seldom been started yet. To successfully implement ACP, new research is needed to identify relevant physician-related barriers and facilitators and to assess how health professionals can facilitate ACP. Further, research is needed to study whether there are differences in willingness to engage in ACP among patients with different illness trajectories, socio-cultural background and religious affiliation and how this may influence the practice of ACP.