King's College London

Research portal

Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model

Research output: Contribution to journalReview article

Standard

Implementing advance care planning with community-dwelling frail elders requires a system-wide approach : An integrative review applying a behaviour change model. / Combes, Sarah; Nicholson, Caroline Jane; Gillett, Karen; Norton, Christine.

In: Palliative Medicine, Vol. 33, No. 7, 01.07.2019, p. 743-756.

Research output: Contribution to journalReview article

Harvard

Combes, S, Nicholson, CJ, Gillett, K & Norton, C 2019, 'Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model', Palliative Medicine, vol. 33, no. 7, pp. 743-756. https://doi.org/10.1177/0269216319845804

APA

Combes, S., Nicholson, C. J., Gillett, K., & Norton, C. (2019). Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model. Palliative Medicine, 33(7), 743-756. https://doi.org/10.1177/0269216319845804

Vancouver

Combes S, Nicholson CJ, Gillett K, Norton C. Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model. Palliative Medicine. 2019 Jul 1;33(7):743-756. https://doi.org/10.1177/0269216319845804

Author

Combes, Sarah ; Nicholson, Caroline Jane ; Gillett, Karen ; Norton, Christine. / Implementing advance care planning with community-dwelling frail elders requires a system-wide approach : An integrative review applying a behaviour change model. In: Palliative Medicine. 2019 ; Vol. 33, No. 7. pp. 743-756.

Bibtex Download

@article{d82d4ac97e1e4a9cb7b2951d69224640,
title = "Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model",
abstract = "BACKGROUND: Facilitating advance care planning with community-dwelling frail elders can be challenging. Notably, frail elders' vulnerability to sudden deterioration leads to uncertainty in recognising the timing and focus of advance care planning conversations.AIM: To understand how advance care planning can be better implemented for community-dwelling frail elders and to develop a conceptual model to underpin intervention development.DESIGN: A structured integrative review of relevant literature.DATA SOURCES: CINAHL, Embase, Ovid Medline, PsycINFO, Cochrane Library, and University of York Centre for Reviews and Dissemination. Further strategies included searching for policy and clinical documents, grey literature, and hand-searching reference lists. Literature was searched from 1990 until October 2018.RESULTS: From 3043 potential papers, 42 were included. Twenty-nine were empirical, six expert commentaries, four service improvements, two guidelines and one theoretical. Analysis revealed nine themes: education and training, personal ability, models, recognising triggers, resources, conversations on death and dying, living day to day, personal beliefs and experience, and relationality.CONCLUSION: Implementing advance care planning for frail elders requires a system-wide approach, including providing relevant resources and clarifying responsibilities. Early engagement is key for frail elders, as is a shift from the current advance care planning model focussed on future ceilings of care to one that promotes living well now alongside planning for the future. The proposed conceptual model can be used as a starting point for professionals, organisations and policymakers looking to improve advance care planning for frail elders.",
keywords = "Advance care planning, aged, behavioural change, communication, end-of-life care, frail elderly, systematic review",
author = "Sarah Combes and Nicholson, {Caroline Jane} and Karen Gillett and Christine Norton",
year = "2019",
month = jul,
day = "1",
doi = "10.1177/0269216319845804",
language = "English",
volume = "33",
pages = "743--756",
journal = "Palliative Medicine",
issn = "0269-2163",
number = "7",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Implementing advance care planning with community-dwelling frail elders requires a system-wide approach

T2 - An integrative review applying a behaviour change model

AU - Combes, Sarah

AU - Nicholson, Caroline Jane

AU - Gillett, Karen

AU - Norton, Christine

PY - 2019/7/1

Y1 - 2019/7/1

N2 - BACKGROUND: Facilitating advance care planning with community-dwelling frail elders can be challenging. Notably, frail elders' vulnerability to sudden deterioration leads to uncertainty in recognising the timing and focus of advance care planning conversations.AIM: To understand how advance care planning can be better implemented for community-dwelling frail elders and to develop a conceptual model to underpin intervention development.DESIGN: A structured integrative review of relevant literature.DATA SOURCES: CINAHL, Embase, Ovid Medline, PsycINFO, Cochrane Library, and University of York Centre for Reviews and Dissemination. Further strategies included searching for policy and clinical documents, grey literature, and hand-searching reference lists. Literature was searched from 1990 until October 2018.RESULTS: From 3043 potential papers, 42 were included. Twenty-nine were empirical, six expert commentaries, four service improvements, two guidelines and one theoretical. Analysis revealed nine themes: education and training, personal ability, models, recognising triggers, resources, conversations on death and dying, living day to day, personal beliefs and experience, and relationality.CONCLUSION: Implementing advance care planning for frail elders requires a system-wide approach, including providing relevant resources and clarifying responsibilities. Early engagement is key for frail elders, as is a shift from the current advance care planning model focussed on future ceilings of care to one that promotes living well now alongside planning for the future. The proposed conceptual model can be used as a starting point for professionals, organisations and policymakers looking to improve advance care planning for frail elders.

AB - BACKGROUND: Facilitating advance care planning with community-dwelling frail elders can be challenging. Notably, frail elders' vulnerability to sudden deterioration leads to uncertainty in recognising the timing and focus of advance care planning conversations.AIM: To understand how advance care planning can be better implemented for community-dwelling frail elders and to develop a conceptual model to underpin intervention development.DESIGN: A structured integrative review of relevant literature.DATA SOURCES: CINAHL, Embase, Ovid Medline, PsycINFO, Cochrane Library, and University of York Centre for Reviews and Dissemination. Further strategies included searching for policy and clinical documents, grey literature, and hand-searching reference lists. Literature was searched from 1990 until October 2018.RESULTS: From 3043 potential papers, 42 were included. Twenty-nine were empirical, six expert commentaries, four service improvements, two guidelines and one theoretical. Analysis revealed nine themes: education and training, personal ability, models, recognising triggers, resources, conversations on death and dying, living day to day, personal beliefs and experience, and relationality.CONCLUSION: Implementing advance care planning for frail elders requires a system-wide approach, including providing relevant resources and clarifying responsibilities. Early engagement is key for frail elders, as is a shift from the current advance care planning model focussed on future ceilings of care to one that promotes living well now alongside planning for the future. The proposed conceptual model can be used as a starting point for professionals, organisations and policymakers looking to improve advance care planning for frail elders.

KW - Advance care planning

KW - aged

KW - behavioural change

KW - communication

KW - end-of-life care

KW - frail elderly

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85065546798&partnerID=8YFLogxK

U2 - 10.1177/0269216319845804

DO - 10.1177/0269216319845804

M3 - Review article

C2 - 31057042

VL - 33

SP - 743

EP - 756

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 7

ER -

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454