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P-59 Advance care planning for older people with advanced heart failure: Typology of patients’ perception
  1. Lena Werdecker1,
  2. M Kujawa1,
  3. N Schneider2 and
  4. G Neitzke1
  1. 1Hannover Medical School, Institute for History, Ethics Und Philosophy of Medicine, Hannover, Germany
  2. 2Hannover Medical School, Institute for General Practice, Hannover, Germany

Abstract

Background Many patients with advanced heart failure (AHF) do not estimate their disease as life-limiting. Often, patients have a lack of knowledge about their health status, the prognosis, and treatment options. Communication about end-of-life care preferences has been neglected for this group in Germany, so far. Therefore, we developed an advance care planning (ACP) consultation for older patients (70 years and older) with AHF.

Aim To gain insight into the patients’ perception of the ACP consultation.

Methods A trained physician facilitated ACP consultation in about 20 patients in a geriatric hospital. The patients’ perceptions were evaluated using semi-structured interviews. Both the consultations and interviews were recorded and transcribed verbatim. We analysed the data according to the qualitative content analysis and identified patterns.

Results Preliminary analyses reveal the following three types of patients’ perceptions: a) patients who are keen on ACP; b) patients who already have an advance directive and consider ACP finished; c) patients who find it difficult to talk about end-of-life care preferences.

Discussion In all three subgroups specific elements of ACP are useful. Even if patients already have an advance directive, they often have a lack of knowledge about its content and impact. This indicates the necessity of a basic education about ACP – in addition to information about their disease.

Conclusion The preliminary findings suggest that ACP consultations should be individually tailored to each patient. Both the appropriate time for initiation and a familiar facilitator appear to be decisive for an open ACP discussion in this patient group.

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