Research Abstract: Free Paper - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Geriatrician input into goals of care and advance care planning in residential aged care facilities  (#126)

Dolly D Png 1 , Phu Sabei PS Shwe 1 , Rosa R Gualano 1 , Jennifer J Pace 1 , Adam Mohd AM Idris 1
  1. Monash Health, Clayton, VICTORIA, Australia

Aims: Shared decision making is key to better health outcomes. Healthcare professional involvement and other factors can affect the validity of documentation of patient goals of care (GOC) and advance care planning (ACP) (1,2,3). This study aimed to assess if geriatrician input improved the experience of clinicians involved in GOC and ACP (4). 

Methods: A consultant geriatrician carried out those discussions either in person or via telehealth at four public residential aged care facilities (RACF) in Melbourne from December 2020 to April 2022. RACF staff were briefed to observe and participate in these discussions. A voluntary survey was then distributed to 30 respondents, consisting of general practitioners (GP; n=2), registered nurses (RN; n=13) and enrolled nurses (EN; n=15). Half (n=15) had received some prior education in GOC and ACP. 

Results: Participants were surveyed on their confidence in knowledge and application of GOC and ACP, prior to and post geriatrician involvement. Both RN and EN demonstrated a decrease in confidence, as compared to GPs. Those who had prior education had a smaller drop in confidence than those who had not. 83% (n=25) reported that geriatrician input was helpful overall. >75% of the staff were keen to have further education on ACP.

Conclusions: Our pilot study findings suggest a knowledge gap in understanding the complexity of ACP discussions among RACF staff. The holistic input of a geriatrician has highlighted the value of specialist staff education in GOC and ACP. There are plans for further training and evaluation of this among the diverse RACF workforce.

 

 

 

 

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