ArticleInnovation in aging2026
Advance care planning by proxy for residential aged care facility residents: results of a pilot interventional study.
Article in Innovation in aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04779684 (Promoting Self-determination for Institutionalized Older People Without Decision-making Capacity), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Promoting Self-determination for Institutionalized Older People Without Decision-making Capacity: Advance Care Planning by Proxy
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6 authors.
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Abstract
Background and Objectives: Advance care planning (ACP) allows people with decision-making capacity (DMC) to stipulate their wishes for medical treatment if they lose this capacity. However, many lose DMC before expressing their treatment wishes. Supplementary ACP models, conducted with health care proxies (HCPs), could promote care that is as coherent as possible with the presumed wishes of people who have lost medical DMC. This study pilot-tested an ACP-by proxy (ACP-bp) intervention with HCPs of residential aged care facility (RACF) residents lacking medical DMC to examine the acceptability and feasibility of the intervention. Research Design and Methods: 21 HCPs of 20 RACF residents participated in this multi-method evaluation of a single-arm intervention pilot study. Proxy decisional conflict and facilitator (RACF health professionals) self-efficacy were measured pre- and post-intervention. Semi-structured interviews were conducted with HCPs and facilitators. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Results: The intervention significantly reduced proxy decisional conflict. Feasibility was threatened by health professional, proxy, and physician time, and RACF health professional turnover. Proxies and facilitators indicated that ACP-bp promoted in-depth discussions of residents' lives, thereby improving health professionals' knowledge and connection with residents, as well as proxy confidence. It promoted communication and cooperation between proxies and health professionals and provided clear documentation in case of emergency. Discussion and Implications: The intervention was acceptable for all participants. Future research should focus on the most efficient models for implementing ACP-bp and establish their validity in promoting care that is coherent with patient wishes through a cluster randomized control study. Clinical Trial Registration Number: NCT04779684.
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