RT Journal Article
SR Electronic
T1 Advance care planning participation by people with dementia: a cross-sectional survey and medical record audit
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP bmjspcare-2020-002550
DO 10.1136/bmjspcare-2020-002550
A1 Jamie Bryant
A1 Marcus Sellars
A1 Amy Waller
A1 Karen Detering
A1 Craig Sinclair
A1 Rasa Ruseckaite
A1 Ben White
A1 Linda Nolte
YR 2021
UL http://spcare.bmj.com/content/early/2021/03/03/bmjspcare-2020-002550.abstract
AB Objectives To describe among individuals with dementia: (1) self-reported awareness of, and engagement in, advance care planning; (2) presence of advance care planning documentation in the health record and (3) concordance between self-reported completion of advance care planning and presence of documentation in the health record.Methods An Australian prospective multicentre audit and cross-sectional survey. Individuals diagnosed with dementia who were able to speak English and were judged by a healthcare provider as having decision-making capacity were recruited from self-selected hospitals, residential aged care facilities and general practices across Australia.Results Fifty-two people with dementia completed surveys and were included. Overall, 59.6% of participants had heard about advance care planning and 55.8% had discussed advance care planning with someone, most often a family member (48.1%). While 38.5% of participants had appointed a medical substitute decision maker, only 26.9% reported that they had written down their values and preferences for future care. Concordance between self-reported completion of advance care planning and presence of documentation in the health record was low (56.8%, κ=0.139; 57.7%, κ=0.053).Conclusion Effective models that promote discussion, documentation and accessible storage of advance care planning documents for people with dementia are needed.