ArticleJournal of the American Medical Directors Association2021
Changes in Advance Care Planning for Nursing Home Residents During the COVID-19 Pandemic.
Article in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- A feasibility trial of advance care planning for patients with terminal cancer in primary hospitals.BMC palliative care · 2025Article
- Falls in focus: an analysis of the rate of falls in 25 Australian residential aged care facilities from 2019 to 2021, pre- and during COVID-19 lockdowns.BMC health services research · 2024Article
- Comprehensive geriatric assessment as an essential tool to register or update DNR codes in a tertiary care hospital.European geriatric medicine · 2024Article
- Situation, Education, Innovation, and Recommendation: A Large-Scale Systematic Review of Advance Care Planning in the Age of COVID-19.Healthcare (Basel, Switzerland) · 2024Review
- Treatment and Care for Nursing Home Residents with COVID-19: A Qualitative Study.Journal of multidisciplinary healthcare · 2024Article
- Analysis of Concentrated COVID-19 Outbreaks in Elderly Facilities in Suita City, Osaka Prefecture, Japan.International journal of environmental research and public health · 2023Article
- Review
- Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis.Palliative medicine · 2023Review
- Survey of Advance Care Planning Practices in Elderly COVID-19 Patients: A Multicenter Questionnaire Survey.Cureus · 2023Article
- Advanced care planning in the early phase of COVID-19: a rapid review of the practice and policy lessons learned.Frontiers in health services · 2023Review
- Intensity of care in cancer patients in the last year of life: a retrospective data linkage study.British journal of cancer · 2022Article
- Health impact of the first and second wave of COVID-19 and related restrictive measures among nursing home residents: a scoping review.BMC health services research · 2022Article
- Implementation of advance care planning amid the COVID-19 crisis: A narrative review and synthesis.Geriatrics & gerontology international · 2021Review
- Feasibility and acceptability of a web-based advance care plan for dementia.Geriatric nursing (New York, N.Y.)Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDescribe the care preference changes among nursing home residents receiving proactive Advance Care Planning (ACP) conversations from health care practitioners during the COVID-19 pandemic.
designRetrospective chart review. SETTING AND
participantsNursing home residents (n = 963) or their surrogate decision makers had at least 1 ACP conversation with a primary health care practitioner between April 1, 2020, and May 30, 2020, and made decisions of any changes in code status and hospitalization preferences.
methodsHealth care practitioners conducted ACP conversations proactively with residents or their surrogate decision makers at 15 nursing homes in a metropolitan area of the southwestern United States between April 1, 2020, and May 30, 2020. ACP conversations reviewed code status and goals of care including Do Not Hospitalize (DNH) care preference. Resident age, gender, code status, and DNH choice before and after the ACP conversations were documented. Descriptive data analyses identified significant changes in resident care preferences before and after ACP conversations.
resultsBefore the most recent ACP discussion, 361 residents were full code status and the rest were Out of Hospital Do Not Resuscitate (DNR). Of the individuals with Out of Hospital DNR, 188 residents also chose DNH. After the ACP conversation, 88 residents opted to change from full code status to Out of Hospital DNR, thereby increasing the percentage of residents with Out of Hospital DNR from 63% to 72%. Almost half of the residents decided to keep or change to the DNH care option after the ACP conversation. CONCLUSION AND IMPLICATIONS: Proactive ACP conversations during COVID-19 increased DNH from less than a quarter to almost half among the nursing home residents. Out of Hospital DNR increased by 9%. It is important for all health care practitioners to proactively review ACP with nursing home residents and their surrogate decision makers during a pandemic, thereby ensuring care consistent with personal goals of care and avoiding unnecessary hospitalizations.
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