title: Advance care planning for institutionalised older people: an integrative review of the literature.
abstract: BACKGROUND
  This integrative review of the literature describes the evolution in knowledge and the paradigm shift that is necessary to switch from advance directives to advance care planning.
  
  
  OBJECTIVE
  It presents an analysis of concepts, trends, models and experiments that enables identification of the best treatment strategies, particularly for older people living in nursing homes.
  
  
  METHODS
  Based on 23 articles published between 1999 and 2012, this review distinguishes theoretical from empirical research and presents a classification of studies based on their methodological robustness (descriptive, qualitative, associative or experimental).
  
  
  RESULTS
  It thus provides nursing professionals with evidence-based information in the form of a synthetic vision and conceptual framework to support the development of innovative care practices in the end-of-life context. While theoretical work places particular emphasis on the impact of changes in practice on the quality of care received by residents, empirical research highlights the importance of communication between the different persons involved about care preferences at the end of life and the need for agreement between them.
  
  
  CONCLUSIONS
  The concept of quality of life and the dimensions and factors that compose it form the basis of Advance care planning (ACP) and enable the identification of the similarities and differences between various actors. They inform professionals of the need to ease off the biomedical approach to consider the attributes prioritised by those concerned, whether patients or families, so as to improve the quality of care at the end of life.
  
  
  CONCLUSIONS
  It is particularly recommended that all professionals involved take into account key stakeholders' expectations concerning what is essential at the end of life, to enable enhanced communication and decision-making when faced with this difficult subject.
authors.affiliation: University Institute of Graduate Studies and Research in Care - IUFRS, University Hospital Center, University of Lausanne, Lausanne, Switzerland; University of Applied Sciences and Arts Western Switzerland, Nursing Department, School of Health Sciences, Geneva, Switzerland.
authors.forename: Laurence
authors.initials: L
authors.lastname: Séchaud
authors.forename: Céline
authors.initials: C
authors.lastname: Goulet
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
authors.forename: Claudia
authors.initials: C
authors.lastname: Mazzocato
mesh_terms: D032722:Advance Care Planning; D000368:Aged; D006801:Humans; D007326:Institutionalization; D009735:Nursing Homes
keywords: advance care planning; advance directives; older person