Date Approved

12-2014

Graduate Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Ruth Ann Brintnall

Second Advisor

Cynthia Beel-Bates

Third Advisor

Paul Reitemeier

Abstract

The purpose of this project was to explore the perceptions of residential elders following a facilitated advance care planning (ACP) conversation. While literature is available regarding ACP and advance directives (ADs), there is minimal knowledge of first hand experiences from those who complete ACP and live in a residential or retirement community. Five residents of a retirement community who participated in facilitated ACP conversations also participated in a focus group interview to explore their perceptions of facilitators of and barriers to ACP and completing an AD. The interview was audio recorded and transcribed verbatim. Then the transcript was reviewed for accuracy and field notes were added to preserved nuances observed during the focus group. The transcription was analyzed for themes to determine residents’ perceptions of their ACP experience. All of the residents had previously participated in some form of ACP prior to the facilitated conversation, and of interest all made changes to their documentation following the conversation. The facilitators for ACP included: future preparedness; having something in writing; feeling of comfort; communication; family involvement; advancing age; knowledge of future death; lack of fear about death; wanting to have a peaceful death; previous experience with loss of a loved one; preventing burden to families by planning ahead; and Christian faith. The barrier for ACP was uncertainty in illness. All participants agreed it was a barrier to their ACP decision-making. Implications for practice are limited to similar residential populations in a select Midwestern city. Suggestions include encouraging residents to: participate in facilitated ACP conversations, revisit the document annually, integrate ACP into an annual visit, and encourage advocate and family involvement in the ACP process.

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