Background Advance care planning (ACP) is often discussed with next-of-kins (NOK) as nursing home (NH) residents have lost decision-making capacity (DMC). This may result in a care plan that may not be truly reflective of the values and care preferences of the residents. It is increasingly paramount to bring ACP conversations upstream and discuss it with residents while they can still communicate and make decision. Project RESPECT (RESpecting Preferences, Empowering Conversations Together) was initiated in March 2021 to enhance ACP culture and improve uptake in the NH over 3 years
Objectives Support NHs in building a sustainable culture of ACP and increasing ACP uptake.
Methods Retrospective evaluation of the project was conducted through an analysis of the five key elements in designing and sustaining an effective ACP program curated by Respecting Choices (USA), namely leadership support, ACP facilitator certification, system redesign, community engagement and continuous quality improvement.
Results Results were drawn from commencement to mid-point reviews of Project RESPECT. Eight NH partners are recruited to achieve the above objectives. 343 advocates and 72 facilitators have since been trained from the NHs and affiliated centres. Despite language barrier, lack of time and confidence to facilitate ACP, the project’s Coordinators completed 23 advocacy and 42 mentoring sessions for NHs.
The Coordinators conducted two educational talks on ACP for NOK of residents and reached out to 34 attendees. NHG Health Services Outcome Research is also involved in an ongoing study to assess knowledge and attitudes towards ACP training and discussion. 49 staff and 30 residents/NOK had since been engaged in this study.
Conclusion Through the partnership with the NH on ACP, Project RESPECT has shown some encouraging results on ACP advocacy and uptake, as part of the continuing efforts to enable staff to make ACP as part of care in nursing homes.