Advance Care Planning (ACP) ensures recognition of a person's wishes and promotes autonomy, however, completion and implementation has been a challenge. To assess the prevalence of ACP in patients from Residential Aged Care Facilities (RACFs) referred to the ‘Residential In-reach’ service of Alfred Health known as Mobile Assessment and Treatment Service (MATS), and to assess how the process of ACP has been approached by the mangers of those facilities. Part A: Prospective audit of documentation of ACP for 100 patients referred to MATSPart B: De-identified, paper-based surveys of the managers of the RACFs where the patients from part A of the study were residing. Part A: The prevalence of ACP, Medical Enduring Power Of Attorney and ‘Not for Resuscitation’ form were 38%, 37% and 35%, respectively. Patients with ACP or a separate ‘NFR’ form were significantly more likely to be living in high care compared to low care facilities (79% vs 21%, p=0.049 and 80% vs 20%, p=0.032, respectively).Part B: There was a significant inconsistency between the facilities with regards to ‘facility requirements’ for ACP, ‘person responsible’, ‘documentation’ and ‘GP involvement’.DiscussionThis study found a low prevalence of ACP, MEPOA and ‘NFR’ form in patients from RACFs referred to MATS. There was also lack of a systematic approach in the process of ACP. There is a need for structured policy coupled with appropriate funding as well as further education of both public and health professionals.
Related Content
Documentation of advance end of life care wishes in two australian residential aged care facilities
Healthcare professionals often lack awareness of patients' wishes regarding end-of-life care (EOLC). Existing data suggest low utilisation and poor application rates of advance care directives in Australian residential aged care facilities (RACF). Southern Health RACFs use separate forms to docum...


Development and evaluation of an aged care specific Advance Care Plan
To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the i...
Piloting an integrated approach of advance care planning for an elderly population within a provincial city
Advance Care Planning (ACP) has been introduced into New Zealand in recent years. New Zealand National ACP Cooperative has developed ACP tools and resources. Wanganui is a provincial region (population 62 000 and above average elderly age group), and took the opportunity to take an integrated app...


The state of play: current advance care planning (acp) practice in residential aged care in one regular australian area health service
Respecting Patient Choices (RPC) model of ACP has been established in Australia for 10 years. Peninsula Health has 35 residential aged care facilities (RACF) in its catchment area, yet few residents present to acute care with an ACP. To assess the current levels of ACP implementation including th...
Managing brain metastases patientswith and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic
A new ambulatory consultative clinic with integrated assessments by palliative care, radiation oncology, and allied health professionals was introduced to (1) assess patients with brain metastases at a regional comprehensive cancer center and inform and guide patients on management strategies, in...

Geriatric consultation service in emergency department: how does it work?
Hong Kong is having a significant prevalence of geriatric patients who usually require admission after presentation to the hospital through emergency departments. The geriatric consultation programme ‘We Care’ aims at lowering acute geriatric medical admission. The study aims at analy...
Following the patient journey: Older persons’ experiences of emergency departments and discharge
There has been little research to date which focuses on patients’ experience of emergency department (ED) care, and transfer to in-patient treatment. This is an essential perspective to identify as it has the potential to impact on future planning and service development. This study was designe...

The balancing point: understanding uptake of advance directive forms in a rural Australian community
The study was conducted in Western Australia, focusing on the attitudes of older, rural, non-hospitalised people towards newly legislated advance care planning (ACP) documents. This study explored baseline awareness and perception of advance directive (AD) forms and factors relevant to their util...
Quality of advance care planning policy and practice in residential aged care facilities in Australia
To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. DesignSurveys of participating organisations concerning ACP-re...

Rapid access rather than open access leads to improved effectiveness of an ENT emergency clinic
An Ear, Nose and Throat (ENT) emergency clinic provides important access to specialist care for patients referred by General Practitioners (GPs), Emergency Departments and doctors on non-ENT hospital wards. The aim is to enable the prompt diagnosis and management of acute conditions, within an op...