Background Worldwide, every three seconds someone develops dementia. Dementia is a terminal condition. Therefore, communication about future care preferences (advance care planning, ACP) is important for people with dementia (PwD) and their network. This review of reviews aims to synthesize the evidence on ACP for PwD and their carers.
Methods PubMed, CINAHL Plus, SCOPUS, SocialCareOnline and Cochrane Library, were systematically searched for systematic reviews in July 2018. After tabulation of primary research, PubMed, CINAHL Plus and SCOPUS were searched for additional recent primary research articles in September. Methodological quality was assessed using AMSTAR-2 and the Joanna Briggs Institute instruments. Overarching themes were identified.
Results 19 reviews and 10 primary research articles met the inclusion criteria. Methodological quality was variable. Preliminary analysis suggests that ACP interventions led to increased ACP documentation, an increase in PwD dying in their preferred place and a decrease in hospitalisations. Qualitative data showed that the ACP process can be experienced as stressful, but is also perceived as relevant by PwD and carers. Lack of knowledge about ACP and dementia were barriers to ACP use for all parties involved. Facilitators for ACP were; education to improve healthcare professionals’ communication skills and legal and ethical knowledge; education for PwD and carers about the ACP process, the differences between palliative and terminal care and the dementia disease trajectory.
Conclusion ACP interventions have shown to be effective on health utilization outcomes, however education for all parties involved is key to optimize the ACP process for PwD and their carers.
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