Preconditions for successful advance care planning in nursing homes: A systematic review.
Abstract
Objectives There is growing evidence of the potential effectiveness of advance care planning. Yet important knowledge gaps remain regarding the preconditions for successful implementation of advance care planning in the nursing home setting. We aim to identify the preconditions related to successful advance care planning in the nursing home setting. By specifying those, we would be able to make well-founded choices for the future design and planning of advance care planning intervention programs.Design A systematic review.Data sources PubMed, PsycINFO, EMBASE and CINAHL.Review methods Two authors independently screened publications. One author assessed methodological quality and extracted textual data, which was double-checked for a random sample. We extracted textual data and used thematic synthesis to identify "preconditions", defined as requirements, conditions and elements necessary to achieve the desired outcome of advance care planning, i.e. attaining concordance between residents' preferences and actual care or treatment received at the end of life.Main findings Based on 38 publications, we identified 17 preconditions at five different levels: resident, family, health-care professional, facility and community. Most preconditions were situated on multiple levels but the majority addressed professionals and the nursing home itself. We summarized preconditions in five domains: to have sufficient knowledge and skills, to be willing and able to participate in advance care planning, to have good relationships, to have an administrative system in place, and contextual factors supporting advance care planning within the nursing home.Conclusion There are multiple preconditions related to successfully implementing advance care planning in the complex nursing home setting that operate at micro, meso and macro level. Future interventions need to address these multiple domains and levels in a whole-system approach in order to be better implementable and more sustainable, while simultaneously target the important role of the health-care professional and the facility itself.
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Persons with dementia are marginalized when it comes to ACP due to barriers associated with a decline in cognitive capacity.
“As it is, persons with dementia are marginalized when it comes to ACP due to barriers associated with a decline in cognitive capacity [44].”
From Acceptability of the voice your values, an advance care planning intervention in persons living with mild dementia using videoconferencing technology (2022) · cites this paper as [44]
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- Authors
- Gilissen, J., Pivodic, L., Smets, T., Gastmans, C., Vander Stichele, R., Deliens, L., & Van den Block, L.
- Affiliations
- Vrije Universiteit Brussel (BE)
- KU Leuven (BE)
- Corresponding author
- Gilissen, Joni
- Pivodic, Lara
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 66
- Pages
- 47-59
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W2560217146
- Cited by
- 156
- References
- 86
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 14 · 2023: 9 · 2022: 27 · 2021: 27 · 2020: 14 · 2019: 25 · 2018: 20 · 2017: 2
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- advance care planning, nursing homes, end-of-life care, resident preferences, family involvement, interprofessional relations, administrative system, whole systems approach, long-term care
- MeSH terms
- Nursing Homes, Advance Care Planning
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