Background
Advance care planning (ACP) aims to empower patient autonomy, and is associated with improved end of life outcomes, patient and family satisfaction. Despite this however, there are relatively low rates of completion in the general population. As such, many studies have explored patient, family and clinician perspectives on ACP. Geriatricians care for diverse patients with chronic and complex conditions and are likely to have a unique perspective on ACP. Â
Aims
This study aims to explore the perspectives of Geriatricians regarding their practices and perspectives on ACP.
Methods
Participants were Geriatricians (n=12) practising in one of two hospitals within NSW. Qualitative methodology using semi-structured interviews was utilized and thematic analysis performed using an inductive approach.
Results
Twelve interviews were conducted, with six major themes were identified: 1. Nuance and flexibility 2. Beneficence 3. Taking responsibility 4. Overcoming challenges 5. Decision-making and 6. Family. Some of the subthemes included ACP should be flexible, promoting transparency in decision-making, ACP is a core part of Geriatrics.
Conclusion
Geriatricians are a group of clinicians familiar with and comfortable discussing ACP. They believe in its beneficence and advocate for wider implementation and earlier discussions. The main benefits related to improved communication, avoidance of unwanted or unhelpful interventions, and empowering patients to make choices about their healthcare. Geriatricians have interesting insights into unique challenges and how to overcome them, as well as decision-making related to ACP.