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Views of advance care planning in older hospitalized patients following an emergency admission: A qualitative study.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Bielinska, Anna-Maria  ORCID logo  https://orcid.org/0000-0001-8668-771X
Soosaipillai, Gehan 
Riley, Julia 
Darzi, Ara 
Urch, Catherine 

Abstract

BACKGROUND: There is increasing evidence of the need to consider advance care planning (ACP) for older adults who have been recently admitted to hospital as an emergency. However, there is a gap in knowledge regarding how to facilitate ACP following acute illness in later life. AIM/OBJECTIVES: To explore the perceived impact of ACP on the lives of older persons aged 70+ who have been acutely admitted to hospital. METHOD: Semi-structured qualitative interviews were conducted with older adults aged 70+ who were admitted to hospital as an emergency. Thematic analysis was enhanced by dual coding and exploration of divergent views within an interdisciplinary team. RESULTS: Twenty participants were interviewed. Thematic analysis generated the following themes: (1) Bespoke planning to holistically support a sense of self, (2) ACP as a socio-cultural phenomenon advocating for older persons rights, (3) The role of personal relationships, (4) Navigating unfamiliar territory and (5) Harnessing resources. CONCLUSION: These findings indicate that maintaining a sense of personal identity and protecting individuals' wishes and rights during ACP is important to older adults who have been acutely unwell. Following emergency hospitalization, older persons believe that ACP must be supported by a network of relationships and resources, improving the likelihood of adequate preparation to navigate the uncertainties of future care in later life. Therefore, emergency hospitalization in later life, and the uncertainty that may follow, may provide a catalyst for patients, carers and healthcare professionals to leverage existing or create new relationships and target resources to enable ACP, in order to uphold older persons' identity, rights and wishes following acute illness.

Description

Funder: NIHR Imperial Biomedical Research Centre


Funder: National Institute for Health Research (NIHR)

Keywords

Acute Disease, Advance Care Planning, Aged, Aged, 80 and over, Hospitalization, Humans, Patients, Qualitative Research

Journal Title

PLoS One

Conference Name

Journal ISSN

1932-6203
1932-6203

Volume Title

17

Publisher

Public Library of Science (PLoS)