Communication about the end of life in nursing homes: a cluster randomised controlled trial (FWOAL735)

Advance care planning (ACP) is a continuous, early-initiated process of communication between care providers, patients and families about the goals and desired direction of future health care, in the event that the patient should become incompetent. Contemporary ACP models are not only focused on preparing for incapacity, but also on empowering competent people to have a say about their treatment. While ACP has been advocated widely across and outside Europe, particular for older nursing home residents, there is limited evidence on its effectiveness in terms of resident's and family outcomes. We will perform a cluster randomized controlled trial investigating the effect of ACP on the residents' and family quality of life, the expression and documentation of wishes concerning the end of life and their evaluation of the quality of care. Nursing homes will be randomized to either standard medical care (control) or to standard medical care plus ACP (intervention) using the Respecting Patient Choices model, a program widely implemented in Australia and the US. Over a 1 year period, we will include 400 newly admitted nursing home residents residing in 8 nursing homes (4 intervention and 4 control) in Belgium. Data collection is scheduled for two years and measurements take place before starting ACP, after 6 months and after death. This study will provide high-quality evidence regarding the effectiveness of early communication about the end of life for nursing homes residents.

Keywords:Medical Sociology, communication, palliative care, nursing homes

Disciplines:Applied sociology not elsewhere classified, Applied sociology