Development and the usefulness of an End-of-Life Care Pathway to Support Advanced Care Planning in Assisted Living Facilities for the Elderly - Assessment of implementation rate and necessity -

Abstract

Aim: This study aimed to verify the usefulness of an end-of-life care (EOLC) pathway to aid in advanced care planning for elderly assisted living residents that would ensure their EOLC wishes were respected. Methods: An EOLC pathway was developed that would be easily understood among the general public. We conducted a mail survey with 132 facilities, located in a core city in Gunma prefecture. The self-administered questionnaire assessed whether the EOLC pathway items had been implemented, and whether they were considered to be necessary. Results: Thirty-five facilities responded; 23 agreed to participate and were included in the analysis. Eighteen facilities had experience providing EOLC, while eight had developed EOLC manuals. Ten facilities did not have full-time nurses on staff. Pathway items that scored 90% or above for both implementation and necessity, were “confirmation of sex and family” and “confirmation of who should be responsible for making decisions when necessary.” Over 60% of respondents regarded all pathway items to be necessary, and 20 facilities indicated that it would be useful, confirming a need for the pathway. Discussion: Although the pathway’s usefulness was verified to a certain extent, further evaluation of its use in assisted living settings is necessary.