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P-31 Examining how advance care directives are used for individuals with dementia living in residential accommodation: A literature review
  1. Vivian Masukwedza1,2,
  2. Victoria Traynor1 and
  3. Elizabeth Halcomb1
  1. 1University of Wollongong, Sydney, Australia
  2. 2Hammond Care, Sydney, Australia


Background Advance Care Directives (ACDs) have undergone the greatest development in the United States, Australia and Canada but are less developed in Europe. There are now global initiatives supporting end of life wishes with the World Health  Organisation suggesting such individuals require integrated care, which supports choice and autonomy.

Aims The aim of this study was to understand and explain how Registered Nurses use ACDs for individuals with dementia living in residential accommodation, relating to: (i) introduction of ACDs; (ii) completion of ACDs and (iii) adherence to ACDs for individuals with dementia living in residential accommodation.

Design This study involved selection of literature relevant to addressing the study objectives. A systematic search of academic and grey literature databases was undertaken to locate international studies addressing the study objectives. Also the study employed a network approach where manual searching of the electronically retrieved sources was performed to identify relevant references.

Findings There was: (i) reduced uptake of ACDs; (ii) reduced hospital transfers and costs; (iii) improved psychological well-being of family members and (iv) satisfaction with care and quality of life.

Discussion ACDs enable persons with dementia to participate in decision making for their future care long after losing capacity to do so. This is pertinent since many older individuals are actually very interested in end of life decision-making.

Conclusion There was a scarcity of high quality evidence evaluating the use of ACDs with individuals with dementia. Further research is recommended on the content of ACDs.

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