Article Text
Abstract
Background Apart from the pilot project beizeiten begleiten, Advance Care Planning (ACP) programmes are still not widely implemeted in Germany. There is, however, an increasing number of organisations and individuals offering consultation for advance directives (ADs). So far, there is hardly any knowledge about their consulting profile and thereby the quality of ACP in Germany.
Aim To assess the current status of organisation, actual practice and possible improvement of AD-consultation in Germany and thereby the need for structured ACP-programmes.
Methods A pilot study using a written questionnaire (Likert-Scale) completed by 33 consultants participating in a follow-up meeting of a Bavarian Hospice Academy.
Results A typical consultation is initated by the consulted individual himself, often by family or friends, rarely by stationary facilities. It takes between 60–90 min (73%) and includes one meeting (61%). The age of the consults is predominately between 61–80 years. 27% of the participants have no or rarely knowledge about the health status of the consults. 97% use the same form for AD (Bavarian State Ministery of Justice), 100% inform about a proper custody. 91% suggest to invite a person of trust and report positive experiences of such an involvement. They never or rarely (64%) exchange with other care providers.
Discussion The results of this pilot study show that these current AD consultation practices do not yet fully meet the quality criteria of international ACP-programmes (eg, initiate conversations, ACP process with several meetings, planning with health care provider).
Conclusion It underlines the need for more comprehensive ACP-programmes.