Developing Strategies to Improve Advance Care Planning in Long Term Care Homes: Giving Voice to Residents and Their Family Members

Table 3

Common family and staff strategies/priorities in implementing ACP conversations in LTC homes.

Strategies	Key process	Who	Recommendations
Understanding ACP	Knowing importance of having ACP conversations	Family members, substitute decision makers, and staff	Educate residents, family members, and staff on care options and palliative care services
Preparing for ACP conversations	Knowing the resident well, holistically	Staff	(i) Know residents’ social history; (ii) All staff should be involved in ACP; (iii) Emotional, physical, social, and spiritual care needs are all identified
Facilitating ACP conversations	Knowing how to have conversation	Staff	(i) Create guidelines and resources to assist staff; (ii) Training for skills to initiate conversations; (iii) Creating time/patience for ongoing conversations
Timing ACP conversations	Knowing when ACP conversations should be initiated	Staff	(i) Give information prior to admission to LTC; (ii) Initiate ACP meeting 6–8 weeks after admission; (iii) Continue communication throughout stay in LTC