Cognitively Impaired Older Persons' and Caregivers' Perspectives on Dementia-Specific Advance Care Planning.

Journal of the American Geriatrics Society
Terri R FriedLaura Moreines

Abstract

Advance care planning (ACP) traditionally involves asking individuals about their treatment preferences during a brief period of incapacity near the end of life. Because dementia leads to prolonged incapacity, with many decisions arising before a terminal event, it has been suggested that dementia-specific ACP is necessary. We sought to elicit the perspectives of older adults with early cognitive impairment and their caregivers on traditional and dementia-specific ACP. Qualitative study with separate focus groups for patients and caregivers. Memory disorder clinics. Twenty eight persons aged 65+ with mild cognitive impairment or early dementia and 19 caregivers. Understanding of dementia trajectory and types of planning done; how medical decisions would be made in the future; thoughts about these decisions. No participants had engaged in any written form of dementia-specific planning. Barriers to dementia-specific ACP emerged, including lack of knowledge about the expected trajectory of dementia and potential medical decisions, the need to stay focused in the present because of fear of loss of self, disinterest in planning because the patient will not be aware of decisions, and the expectation that involved family members would...Continue Reading

References

Jan 28, 2009·Journal of the American Geriatrics Society·Adam D SchickedanzRebecca L Sudore
Aug 18, 2010·Annals of Internal Medicine·Rebecca L Sudore, Terri R Fried
Nov 4, 2010·JAMA : the Journal of the American Medical Association·Daniel P Sulmasy, Lois Snyder
Dec 15, 2010·Journal of the American Geriatrics Society·Terri R FriedLynne Iannone
Jul 6, 2013·Palliative Medicine·Jenny T van der SteenUNKNOWN European Association for Palliative Care (EAPC)
Aug 27, 2013·Journal of Pain and Symptom Management·Rebecca L SudoreDeborah E Barnes
Jan 26, 2016·Journal of the American Geriatrics Society·Terri R FriedLynne Iannone
Feb 29, 2016·Journal of the American Medical Directors Association·Bettina Schoene-SeifertDavid Herr
Nov 9, 2017·JAMA : the Journal of the American Medical Association·Barak GasterJ Randall Curtis
Mar 7, 2018·Journal of General Internal Medicine·Halima AmjadQuincy M Samus
Jul 5, 2019·Journal of the American Geriatrics Society·Andrea PaivaTerri R Fried
May 7, 2020·Journal of the American Geriatrics Society·Daniel P Sulmasy
May 7, 2020·Journal of the American Geriatrics Society·Susan E Merel, Barak Gaster

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Citations

May 19, 2021·Journal of the American Geriatrics Society·Andrew B Cohen, Erin S DeMartino
Nov 11, 2021·Geriatrics & Gerontology International·Kana KazawaShinya Ishii

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