Abstract
Taiwan was the first Asian country to endorse patient autonomy, and advance care planning (ACP) has been highly promoted to improve quality of end-of-life (EOL). A mixed-methods pilot survey was conducted in northwestern Taiwan to investigate older community-dwelling residents’ (N = 52) ACP behavioral engagement, socio-demographical correlates, and their preferred intervention strategies. An interview subset (25%, N = 13) was purposely chosen for in-depth feedback and rationales behind their ACP decision-making. Rich information was obtained about perceived facilitators and inhibitors to initiate ACP and preferred intervention strategies in ACP programs. Consistent with previous literature, carefully designed ACP programs that incorporated family decision-making and met older subjects’ multiple needs would increase program acceptability and foster ACP engagement among older Taiwanese in the community setting.
Highlights
Advance care planning (ACP) is a process that aims to support patients’ medical decisions in the event of incompetency [1,2]
Patients will be assured by documented ACP discussions to receive EOL care consistent with their goals, values, and preferences [4]
All fifty-two subjects resided within a 20-mile radius of the study site in northwestern Taiwan
Summary
Advance care planning (ACP) is a process that aims to support patients’ medical decisions in the event of incompetency [1,2]. ACP has been associated with positive patient and caregiver outcomes, including increased quality of remaining life, improved bereavement process, and enhanced psychological well beings [3]. Advanced discussions and practical preparations for “in-the-moment”. 256) [4] provide guidance to family and surrogates, decrease their decisional burdens, and reduce health care providers’ moral distress [5]. Patients will be assured by documented ACP discussions to receive EOL care consistent with their goals, values, and preferences [4]. “reflecting the diverse and often competing needs of patients, health professionals, legislature, and health systems”
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