The ‘we DECide’-intervention: Advance care planning for nursing home residents with dementia

Oral presentationBackground Advance care planning (ACP) is the communication process of preparing care and treatment choices, in anticipation of the moment that persons no longer have decision making capacity. Therefore, ACP is essential in the case of dementia. Since admission to a nursing home is a crucial moment for taking up ACP, nursing home staff are key figures in the ACP process. This process essentially corresponds to the three-step model for shared decision making (SDM). We developed the ‘we DECide’-intervention, in which the basic principles of SDM are trained and implemented in the context of ACP for nursing home residents with dementia. The intervention consists of a training program focusing on knowledge and skills of the Choice Talk, Option Talk and Decision Talk. The aim of the present study is to examine the effects of the ‘we DECide’-intervention. Methods Nursing home staff (n=44) from nine different nursing homes received the ‘we DECide’-intervention. The self-developed IFC-SDM Questionnaire (assessing views on Importance, Frequency and Competence on Shared Decision Making) was administered to the participants at three time points, using a pretest-posttest design: directly before (pretest), directly after (posttest 1), and three months after the intervention (posttest 2). The IFC-SDM Questionnaire was based on the three-step model for SDM and lists nine behaviours, each referring to the Choice Talk, Option Talk or Decision Talk. Participants’ views on importance of and competence in performing these behaviours, and frequency of putting them into practice were assessed with a five-point scale. Findings: At posttest 1, participants’ views on their own competences increased compared to the pretest. Moreover, participants’ views showed less discrepancy between importance and frequency, and between importance and competence. Posttest 2-measurements are ongoing; results will be presented at the conference. Discussion: The ‘we DECide’-intervention shows to be effective in improving particpants’ views on their own competences in applying SDM in ACP conversations. If posttest 2 analyses show that these effects are maintained after three months, a large-scale intervention can be carried out.status: publishe