Advance care planning in long-term care facilities.
Residents of long-term care facilities are at risk of serious medical illnesses and being unable to express choices when difficult treatment decisions must be made. Advance care planning (ACP) allows residents to consider, make, and communicate their preferences for how medical decisions should be made if they are unable to participate in the decision-making process. This article reviews the three steps in ACP: consideration of options and expression of values, communication of decisions, and documentation of the choices. The article defines and describes the particular value of ACP in long-term care facilities, reviews the literature on successful ACP programs in long-term care, and concludes with practical suggestions on how to develop and implement ACP programs.
Cantor
Michael D
MD
Geriatric Research, Education, and Clinical Center (182) Veterans Affairs Boston Health Care System-Jamaica Plain Campus, Jamaica Plain, Massachusetts 02130, USA. Michael.cantor@med.va.gov
Pearlman
Robert A
RA
D032722:Advance Care Planning / Q000331:legislation & jurisprudence / Q000592:standards*; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003657:Decision Making; D006707:Homes for the Aged / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000331:legislation & jurisprudence / Q000592:standards*; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D010358:Patient Participation; D026684:Personal Autonomy; D016730:Program Development; D013727:Terminal Care / Q000458:organization & administration*; D014481:United States