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

Empowering older frail people to make their end of life choices (#139)

Peter Gonski 1 , Melissa Chan 1 , Ken Hillman 2 , Ben Harris-Roxas 3 , Carla Saunders 4
  1. SESLHD, Miranda, NSW, Australia
  2. Simpson Centre for Health Services research, SWSLHD, Sydney, NSW, Australia
  3. SEaRCH, UNSW, sydney, NSW, Australia
  4. Faculty of Health, UTS, Sydney, NSW, Australia

Advance Care Planning (ACP) allows vulnerable patients and their caregivers to plan for a scenario where they may become seriously ill. Ethical and effective ACP can enhance discussions of end-of-life preferences and ensure appropriate healthcare utilisation. This project is a facilitated empowerment approach to advance care planning, by using evidence-based models in patient assessment, healthcare communication and patient empowerment to develop Advance Care Directives (ACD) based on a person-centred discussion. The aim of this research was to trial a research methodology that holds potential for creating empowering dynamics in the advance care planning process. Participants greater than70yrs, MMSE  >24/30 and  English speaking were recruited from aged care clinic outpatients,referrals to community teams and ACAT. A social worker,experienced in ACP conducted the home interviews and used the SPICT score and Rockwood frailty index to characterise the severity of individuals medical and functional status  .Initially 100 participants were to be targeted but the study was stopped after 80 participants were included as results were apparent.Participants who had minimal current health issues and were functionally more independent were more engaged and empowered to complete the ACD.The more frail were inclined to revert decision making to families or carers.This suggests that encouraging the completion of ACD in the elderly population should be directed to the well ,less frail.