Article Text
Abstract
Background Although widely regarded as a good component of good end-of-life planning, the uptake of Advance Care Planning (ACP) in nursing homes is low. ACP is highly relevant for nursing home residents, given that most nursing home residents will eventually die there. It has been predicted that by 2040, the most common place of death will be in a care home.
The focus on individual autonomy as an ethical principle underlying ACP does not resonate with real world settings. Research on patient and family caregiver attitudes and preferences regarding ACP has shown how ACP are impacted on, and determined by, relationships between patients and their family. There is evidence that many patients do make personal choices about future care as autonomous agents, but naturally orient to share responsibility and decision making within the context of relationship with their significant others s and the consequences their illness and care will have for their caregivers .
Uncertainty remains about how ACP should be constituted in different contexts, its role and value for this population group and the criteria by which its efficacy can be confidently and reliably evaluated.
Aim The focus of most studies was on end-of-life cancer patients. The aim of this proposal is to investigate nursing home residents living with chronic diseases and their family members’ experience and appraisal of ACP in the Singapore nursing home context.
Methods An exploratory approach is proposed to unravel the meaning of the experiences by guiding the researcher in gaining a deeper understanding of the human experiences through Braun and Clarke’s thematic analysis using data derived from in-depth semi-structured interviews conducted with a purposive sample of 10 residents and 10 family members, across 5 not-for-profit nursing homes in Singapore.