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PRACTICE OF CONSULTATION FOR ADVANCE DIRECTIVES IN GERMANY: A PILOT STUDY OF CONSULTANTS TRAINED BY A BAVARIAN HOSPICE ACADEMY
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  1. S Petri1 and
  2. G Marckmann1
  1. 1Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University of Munich, Germany

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 initiated by the consulted individual himself, takes between 60–90 min and includes one meeting. The age of the consults is predominately between 61–80 years, they seem to be healthy. 27% of the participants has no or rarely knowledge about the health status of the consults. 97% use the same form for AD (Bayerisches Staatsministerium der Justiz), 100% inform about a proper custody. 91% suggest to invite a person of trust and report a positive experience of such an integration. They never or rarely 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, initiatiate conversations, ACP process with several meetings, planning with health care provider, update of plans).

Conclusion It underlines the need for more comprehensive ACP-programmes.

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