Результаты поиска

Advance care planning.

Advance care planning (ACP) is done in anticipation of something adverse happening and the likelihood of losing the capacity to be involved in future decision making. ACP encourages people to think about what might happen in serious illness scenarios and to consider their needs or wishes. As long-term conditions, multimorbidity, frailty and end-of-life care become more dominant health challenges, planning for future problems and giving patients and their carers the tools to self-manage becomes more imperative. ACP is part of this philosophy of care, anticipating and planning for future health …

Advance Care Planning in Orthopedics.

Given that about two-thirds of adults in the United States have not completed any advance directive, and there are over five million inpatient and outpatient orthopedic surgeries each year, there are unparalleled opportunities to engage with patients in advance care planning (ACP) discussions. ACP is defined as an ongoing strategy to help adults across the lifespan identify and communicate their preferences for medical care, based on their individual values and life goals. To meet the call for more widespread ACP documentation, the first levels of the Patton, Zalon, and Ludwick Policy Assessme…

Advance Care Planning, Race, and Age.

There are well-documented racial disparities in the provision of end-of-life care and advance care planning (ACP). It is unclear whether these observed disparities are explained by other variables. This analysis sought to determine whether any apparent racial disparities among general medicine inpatients in the provision of ACP services persisted after adjustment for potential confounders. The authors conducted a secondary analysis of electronic health records data collected as baseline data for a quality improvement program. The analysis included all patients who were discharged by hospitalis…

Advance Care Planning in Huntington's Disease.

Advance care planning (ACP) is a useful tool that benefits adult patients, care providers, and surrogate decision makers, through providing opportunities for patients to consider, express, and formalize their beliefs, preferences, and wishes pertaining to decisions regarding future medical care at a time when they retain decision-making capacity. Early and timely consideration of ACP discussions is paramount in Huntington's disease (HD) given the potential challenges in ascertaining decision-making capacity in the advanced stages of the disease. ACP helps to empower and extend patient autonomy…

Advance Care Planning in Glioblastoma Patients.

Despite multimodal treatment with surgery, radiotherapy and chemotherapy, glioblastoma is an incurable disease with a poor prognosis. During … ision-making on their future care, including the end of life (EOL) care, which can be achieved with Advance Care Planning (ACP). Although ACP, by definition, aims at timely involvement of patients and proxies in decision-making on future care, the optimal moment to initiate ACP discussions in the disease trajectory of glioblastoma patients remains controversial. Moreov …

Mapping advance care planning and advance directives in Latin America.

BACKGROUND/AIMS: The extent to which low- and middle-income countries have implemented Advance Care Planning (ACP) and Advance Directives (AD) remains unclear. We aimed to map the current status of ACP/AD in Latin America. METHODS: This cross-sectional, mixed-methods survey of ACP/AD in LA comprised interviews with 18 key informants from 18 out of 20 countries, most of whom were appointed by national Palliative Care Associations. Online interviews were conducted with each informant, covering a range of relevant topics from AD regulations to the use of ACP/AD in the context of end-of-life clin…

Survivorship and Advance Care Planning in Cancer.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Совпадение в полном тексте источника
… In this issue, McLendon and colleagues report on the importance of advance care planning (ACP), an essential aspect of survivorship care for the cancer patient population ( McLendon et al., 2025 ). … Despite our busy schedules, unpredictable workloads, and general lack of time, survivorship and advanced care planning should remain a priority when providing high-quality care. …

[Advance care planning in critical care : Potential and requirements].

BACKGROUND: Lack of knowledge about patient preferences is a contributing factor for inappropriate therapy. Advance care planning (ACP) is a novel concept for meaningful advance directives, but it is still not widely known in Germany. OBJECTIVE: An overview of the concept of ACP, development and its implementation with respect to intensive care is provided. METHODS: A narrative literature review was performed. RESULTS: ACP is a broad concept which requires facilitated discussions with trained medical staff. The process can lead to different ACP documents. It is also possible to facilitate d…

Culturally Acceptable Advance Care Planning and Advance Directives for Persons Experiencing Homelessness.

Although the process of dying is a universal human experience, it often magnifies individuals' unique cultural differences. Persons experiencing homelessness (PEHs) have unique barriers, challenges, and wishes for end-of-life care. There is insufficient evidence about how to provide culturally congruent advance care planning (ACP) through advance directive (AD) completion for PEHs. This study addressed this knowledge gap, and its findings serve as the basis for developing additional strategies to promote a satisfying ACP experience for this population when they complete an AD. The purpose of t…

[Advance Care Planning is not a pipe dream!].

The retrospective observational study by Assimakis et al. on Advance Care Planning (ACP) implemented in primary (or general) home palliative care found that 62% of medical records closed due to completion of the care pathway contained a ACP in which the patient's wishes were documented in 83.9% of cases and that of the family members in 90.3%. The PCC was formulated by the General Practitioner (GP) with the patient in all cases except in cases of dementia or delirium, in which it was carried out with a family member previously appointed as a proxy by the patient. In 61% of cases, the community…

Advance care planning uptake in the severely frail.

BACKGROUND: Older adults with severe frailty (Clinical Frailty Scale [CFS] 7-9) have high short-term mortality and are often approaching the end of life. Despite this, uptake of Advance Care Planning (ACP) remains low. This study aimed to examine the rate and timing of ACP referral and completion among hospitalized patients with severe frailty. METHODS: We conducted a retrospective observational study of patients aged ≥ 65 years with documented CFS scores of 7-9 admitted to the geriatric medicine wards of a public tertiary hospital in Singapore between July and September 2024. The primary out…

Advance care planning in patients with respiratory failure.

Advance care planning (ACP) is a complex and iterative communication process between patients, surrogates and clinicians that defines goals of care that may include, but is not limited to, documentation of advance directives. The aim of ACP is to promote patient-centred care tailored to the patient's clinical situation through informed preparation for the future and improved communication between patient, clinicians and surrogates, if the latter need to make decisions on patient's behalf.The aim of this article is to review research related to ACP in acute and chronic respiratory failure, rega…

Advance Care Planning Training for Renal Social Workers.

End Stage Renal Disease (ESRD) is a life-limiting condition for which hospice and palliative care are not routinely provided to patients and families. While the ESRD mortality rate is close to 25%, patients on dialysis are half as likely to receive hospice services than patients with other life-limiting diagnoses. Nephrologists and dialysis social workers receive little training to effectively lead patients with ESRD and their families through the stages of dying and the completion of advance care planning. The lack of professional training, a need for greater commitment to advanced care plann…

Advance Care Planning and HIV Symptoms in Adolescence.

OBJECTIVES: To determine the effect of family-centered pediatric advance care planning (FACE pACP) on HIV-specific symptoms. METHODS: In this single-blinded, randomized controlled trial conducted at 6 US hospital-based HIV clinics, 105 adolescent-family dyads, randomly assigned from July 2011 to June 2014, received 3 weekly sessions in either the FACE pACP arm ([1] pediatric advance care planning survey, [2] Respecting Choices interview, and [3] 5 Wishes directive) or the control arm ([1] developmental history, [2] safety tips, and [3] nutrition and exercise tips). The General Health Assessme…

Advance care planning in haematological malignancies: A qualitative exploratory analysis of the facilitators and barriers to implementing advance care planning in practice.

OBJECTIVES: Advance care planning (ACP) is the process of helping individuals plan for their future by identifying goals of care and preferences for future care, identifying key decision makers should they be unable to make their own decisions. Hemato-oncology is a challenging specialism, one in which the transition from curative to end-of-life can be very rapid, with many patients dying in acute settings while receiving active treatment. As such, it is an area in which ACP is frequently overlooked. This qualitative study aimed to gain a better understanding of the perceived barriers and facil…

Engaging in the Life-planning in Early Alzheimer's and other Dementias advance care planning intervention is associated with perceived advance care planning concordance and interpersonal connectedness.

BACKGROUND AND OBJECTIVES: Persons living with dementia often rely upon a care partner as their surrogate medical decision maker, yet little is known about how dementia care dyads achieve advance care planning (ACP) concordance: when a care partner fully understands a care recipient's values and preferences as best they can. Examining data from a pilot study of the online Life-planning in Early Alzheimer's and other Dementias (LEAD) intervention to better understand how dyads achieve perceived ACP concordance, we hypothesized that: (1) engaging in ACP was associated with perceived ACP concorda…

Proactive Opportunities for Advance Care Planning (PRO-ACP): improving advance care planning completion among hospitalised internal medicine patients with life-limiting illness.

BACKGROUND: Advance care planning (ACP) completion rates remain suboptimal in acute care settings, particularly among patients with life-limiting illnesses (LLIs). This quality improvement initiative aimed to increase ACP completion rates among internal medicine (IM) inpatients with LLI through systematic patient identification and multidisciplinary advocacy. METHODS: The Proactive Opportunities for ACP project was implemented across eight IM wards from April to October 2025, using three Plan–Do–Study–Act cycles. Patients with LLI were systematically identified using International Classificat…

A cross-sectional study on advance care planning documentation attitudes during national advance care planning week in a South-East Asian country.

BACKGROUND: Through advocacy initiatives such as roadshows during "National ACP Week", the Agency for Integrated Care (AIC) had increased advance care planning (ACP) engagement since 2011. Project Happy Apples (PHA), a community initiative project led by medical students from the National University of Singapore, also conducted a public exhibition to raise ACP awareness during this period. This study aimed to investigate and identify predictors of attitudes towards ACP documentation among 'ACP Week' respondents which may be used to formulate strategies to increase ACP documentation in Singapor…