TY - JOUR
T1 - Implementation of an Advance Care Planning Intervention in Nursing Homes
T2 - An International Multiple Case Study
AU - The mySupport Study Group
AU - Brazil, Kevin
AU - Walshe, Catherine
AU - Doherty, Julie
AU - Harding, Andrew J.E.
AU - Preston, Nancy
AU - Bavelaar, Laura
AU - Cornally, Nicola
AU - Di Giulio, Paola
AU - Gonella, Silvia
AU - Hartigan, Irene
AU - Henderson, Catherine
AU - Kaasalainen, Sharon
AU - Loucka, Martin
AU - Sussman, Tamara
AU - Vlckova, Karolina
AU - Van Der Steen, Jenny T.
N1 - Publisher Copyright:
© 2024 The Author(s).
PY - 2024/6/1
Y1 - 2024/6/1
N2 - Background and Objectives: The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention. Research Design and Methods: A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom. Results: Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery. Discussion and Implications: There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.
AB - Background and Objectives: The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention. Research Design and Methods: A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom. Results: Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery. Discussion and Implications: There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.
KW - Comfort care
KW - Decision-making
KW - Dementia
KW - Family caregiver
UR - https://www.scopus.com/pages/publications/85190845721
U2 - 10.1093/geront/gnae007
DO - 10.1093/geront/gnae007
M3 - Article
C2 - 38349015
AN - SCOPUS:85190845721
SN - 0016-9013
VL - 64
JO - Gerontologist
JF - Gerontologist
IS - 6
M1 - gnae007
ER -