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Advanced Care Planning in Hospitals
The role of the community volunteer in advance care planning
  1. G Threlkeld,
  2. B Bidstrup and
  3. J Downing
  1. John Richards Initiative, La Trobe University

Abstract

This presentation reports findings about the volunteer's role in an intervention developed through research to establish an accessible and sustainable model of advance care planning (ACP) for older people in rural communities in south eastern Australia. Entrust-U is innovative for initiating ACP through engaging volunteers in a number of roles, including: focussed interviews which move from an evaluative life review to identify values, a trusted decision-maker, and future wishes for care; preparing a life story from these interviews; facilitating conversations with a trusted decision-maker; and preparing a letter to a participant's General Practitioner.

Existing palliative care volunteers are given additional training for Entrust-U. Using a facilitated action research design, volunteers engaged in piloting the evolving model participated in briefing, training and debriefing, and a focus group. Informed by the principles of interpretative description, thematic analysis of notes and transcripts of these meetings and evaluation interviews identified three emergent orientations taken by volunteers in their role. This emergent new knowledge indicates each orientation brings a different approach to the project, with these differences exemplified in interviewing styles during the evaluative life review and exploration of ACP. A volunteering orientation focussed on inter-personal relations concentrated on building rapport. An orientation focussed on process, approached the interview as a procedure to be followed. An orientation focussed on the task of ACP adopted an instrumental and linear interview approach. Recognition of these volunteer orientations has significant implications for training and coordination of volunteers.

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