Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis

Authors: Spacey, A. and Porter, S.

Journal: Palliative Medicine

Volume: 37

Issue: 5

Pages: 663-676

eISSN: 1477-030X

ISSN: 0269-2163

DOI: 10.1177/02692163221137103

Abstract:

Background: The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem. Aim: To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic. Design: A critical realist review and synthesis. Data Sources: MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022. Results: Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff’s concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff’s confidence and readiness to engage in care planning during pandemic conditions. Conclusion: Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.

https://eprints.bournemouth.ac.uk/37838/

Source: Scopus

Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis.

Authors: Spacey, A. and Porter, S.

Journal: Palliat Med

Volume: 37

Issue: 5

Pages: 663-676

eISSN: 1477-030X

DOI: 10.1177/02692163221137103

Abstract:

BACKGROUND: The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem. AIM: To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic. DESIGN: A critical realist review and synthesis. DATA SOURCES: MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022. RESULTS: Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff's concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff's confidence and readiness to engage in care planning during pandemic conditions. CONCLUSION: Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.

https://eprints.bournemouth.ac.uk/37838/

Source: PubMed

Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis

Authors: Spacey, A. and Porter, S.

Journal: PALLIATIVE MEDICINE

Volume: 37

Issue: 5

Pages: 663-676

eISSN: 1477-030X

ISSN: 0269-2163

DOI: 10.1177/02692163221137103

https://eprints.bournemouth.ac.uk/37838/

Source: Web of Science (Lite)

Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis

Authors: Spacey, A. and Porter, S.

Journal: Palliative Medicine

eISSN: 1477-030X

ISSN: 0269-2163

DOI: 10.1177/02692163221137103

Abstract:

Background: The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem. Aim: To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic. Design: A critical realist review and synthesis. Data Sources: MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022. Results: Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff’s concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff’s confidence and readiness to engage in care planning during pandemic conditions. Conclusion: Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.

https://eprints.bournemouth.ac.uk/37838/

Source: Manual

Preferred by: Sam Porter

Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis.

Authors: Spacey, A. and Porter, S.

Journal: Palliative medicine

Volume: 37

Issue: 5

Pages: 663-676

eISSN: 1477-030X

ISSN: 0269-2163

DOI: 10.1177/02692163221137103

Abstract:

Background

The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem.

Aim

To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic.

Design

A critical realist review and synthesis.

Data sources

MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022.

Results

Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff's concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff's confidence and readiness to engage in care planning during pandemic conditions.

Conclusion

Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.

https://eprints.bournemouth.ac.uk/37838/

Source: Europe PubMed Central

Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis.

Authors: Spacey, A. and Porter, S.

Journal: Palliative Medicine

Volume: 37

Issue: 5

Pages: 663-676

ISSN: 0269-2163

Abstract:

BACKGROUND: The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem. AIM: To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic. DESIGN: A critical realist review and synthesis. DATA SOURCES: MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022. RESULTS: Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff's concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff's confidence and readiness to engage in care planning during pandemic conditions. CONCLUSION: Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.

https://eprints.bournemouth.ac.uk/37838/

Source: BURO EPrints