Background Conversations and decision-making regarding healthcare preferences often occur at points of health shocks or medical emergencies can be overwhelming and stressful. Having early discussions regarding what would matter in an event of serious illness can provide clarity on overall goals of care, and better prepare individuals and their families ahead of time. With Singaporeans living longer but spending more of their twilight years in ill health, there is therefore growing impetus and efforts to bring these important conversations on life and health earlier upstream in the community.
Methods A 4-session psychoeducation group programme was conducted with community dwelling seniors. Session content focuses on life values, experiences, care goals and preferences. Pre-planning tools such as ACP were included, and the participation in the programme culminates in the actualisation of ACP.
Results 7 runs were conducted across two active ageing centres with a total of 60 community dwelling seniors (mean age 71.6 years old) participating in the programme.
Pre-post self-evaluation highlighted an overall increase in participants’ awareness of personal values and preferences, confidence in discussing about future healthcare needs, and knowledge on pre-planning tools. Thematic analysis of participants’ qualitative sharing highlighted the following themes: (i) sense of preparedness and control, (ii) discoveries in knowledge and awareness, (iii) contemplations on life/death, and (iv) communicating wishes/preferences. Overall, feedback survey reported that all participants strongly agreed or agreed that the sessions were useful and relevant to plan for their future healthcare needs. 89% of participants who completed the programme had their ACP actualised.
Conclusion Community engagement using group work as an approach has shown promising results in promoting early conversations surrounding values, preferences and goals of care. Future plans will focus on scaling up outreach and collaboration with community partners to engage residents in planning for their future healthcare needs.
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