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Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities

Street, Maryann, Ottmann, Goetz, Johnstone, Megan-Jane, Considine, Julie and Livingston, Patricia M. 2015, Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities, Health and Social Care in the Community, vol. 23, no. 5, pp. 513-522.

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Title Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities
Author(s) Street, MaryannORCID iD for Street, Maryann orcid.org/0000-0002-5615-141X
Ottmann, Goetz
Johnstone, Megan-Jane
Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Livingston, Patricia M.
Journal name Health and Social Care in the Community
Volume number 23
Issue number 5
Start page 513
End page 522
Total pages 10
Publisher John Wiley
Place of publication Milton, Qld
Publication date 2015-09
ISSN 1365-2524
Keyword(s) advance care planning
advance directives (medical care)
domiciliary aged care
emergency departments
end-of-life care
residential aged care
Summary The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2–6) vs. 6 days (2–10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan.
Language eng
Field of Research 111001 Aged Care Nursing
Socio Economic Objective 920502 Health Related to Ageing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, Wiley
Persistent URL http://hdl.handle.net/10536/DRO/DU:30068082

Document type: Journal Article
Collections: School of Nursing and Midwifery
Centre for Intelligent Systems Research
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