title: Developing a care pathway for advance decisions and powers of attorney: qualitative study.
abstract: BACKGROUND
  The Mental Capacity Act for England and Wales empowers individuals to plan ahead for when they may lack capacity.
  
  
  OBJECTIVE
  To develop a care pathway for advance decisions and powers of attorney using Huntington's disease as an exemplar.
  
  
  METHODS
  Qualitative study using in-depth individual interviews with service users and carers, and focus groups with professionals. Inductive qualitative analysis was used to develop themes to construct a care pathway that was then piloted and further evaluated to achieve a final pathway.
  
  
  RESULTS
  A care pathway was developed that incorporated an early introduction through a formal education session and a minimum of two sessions separated by at least 2 weeks before advance decision completion. Optimal delivery of this intervention requires significant clinical and administrative commitment.
  
  
  CONCLUSIONS
  We have developed a simple, easy-to-follow care pathway that was acceptable to users and providers.
authors.affiliation: Department of Psychological Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK. bissonji@cf.ac.uk
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Bisson
authors.forename: Victoria
authors.initials: V
authors.lastname: Hampton
authors.forename: Anne
authors.initials: A
authors.lastname: Rosser
authors.forename: Søren
authors.initials: S
authors.lastname: Holm
mesh_terms: D016223:Advance Directives / Q000941:ethics* / Q000331:legislation & jurisprudence; D017028:Caregivers; D003657:Decision Making / Q000941:ethics*; D003695:Delivery of Health Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D004739:England; D017144:Focus Groups; D006801:Humans; D007883:Legislation, Medical / Q000941:ethics*; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D010865:Pilot Projects; D016730:Program Development; D036301:Qualitative Research