Background Engaging older community-dwelling healthy adults in ACP discussions is an international public health challenge that requires social strategies to ensure uptake of ACP in non clinical settings.
Aim The entrust-u study developed and tested an approach to ACP with older adults in rural communities that addressed guiding values, appointment of a decision maker, content of ACP discussions for healthy adults, documenting conversations and informing GPs.
Methods Collaborative action research was conducted over three cycles of planning, action, evaluation and reflection to develop and test the entrust-u process. We tested the use of life review, ecomaps and the ‘Go Wish’ game as strategies through interviews, focus groups and analysis of life reviews with 25 older people, 7 palliative care volunteers and four co-ordinators.
Results 25/25 older people completed a Future Wishes document, 18/25 appointed a substitute decision maker and 14/16 requested a follow up letter to their GP. All volunteers completed or re-visited their own MEPOAs and Future Wishes documents. We developed and refined a volunteer training module to be included in the Palliative Care Volunteers Kit that included a Train the Trainer process and a manual for coordinators of volunteers.
Discussion Discussions on preparation for death require a range of strategies and tools. We worked collaboratively with rural community palliative care services to initiate discussions on facing death and ACP through a three-stage flexible structured interview process.
Conclusion Entrust-u used a variety of tools and strategies to successfully involve palliative care volunteers in conducting ACP discussions with older people.
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