Promoting advance care planning education and advance directive completion in the community setting

Abstract

The United States population is aging due, in part, to western medicine's ability to prevent, treat, and cure disease which has allowed the prolongation of life. End-of-life care has become more invasive and, despite the continued focus on patient autonomy, rates of advance directive (AD) completion remain low. Increased knowledge may increase the community dwelling adult population's ability to plan for end-of-life, have end-of-life conversations, complete ADs, and increase individual's autonomy at end-of-life. Purpose: The purpose of this project was to educate community-dwelling adults about the purpose and importance of ADs, encourage conversation about end-of-life planning, encourage completion of ADs in community-dwelling adults of all ages and in doing so, promote personal autonomy. Method: A sample of N=16 community-dwelling adults participated in an educational intervention that contained information on end-of-life planning with a focus on ADs. Pre- and post-intervention surveys were used to gather demographic information, assess AD knowledge and examine participant views on importance of understanding health information and autonomy. Descriptive statistics, qualitative description, and paired-sample t test was used to analyze the data. Outcome: The sample consisted of 16 community-dwelling adults between ages 30 and 84-years old. The five questions assessing AD knowledge Pre- and Post-intervention were scored as correct or incorrect for each participant and total correct responses were computed into a mean score. The results of the paired sample t-test indicates that there was a significant difference between scores for pre-intervention survey (M= 63.75, SD = 22.84) and post-intervention survey (M= 90.0, SD= 10.9, t(4)=3.015, p=.039). Conclusion: The project results indicate that this intervention was effective in increasing AD knowledge, although, the impact on actual AD completion rates was not assessed. Further research is needed to identify successful methods of increasing ACP and AD knowledge in the community-dwelling adult population and also to identify the impact of such programs on actual AD completion.