Future policy and research for advance care planning in dementia: consensus recommendations from an international Delphi panel of the European Association for Palliative Care

European Association for Palliative Care, Miharu Nakanishi, Sandra Martins Pereira, Lieve Van den Block, Deborah Parker, Karen Harrison-Dening, Paola Di Giulio, Jürgen In der Schmitten, Philip J Larkin, Ninoslav Mimica, Rebecca L Sudore, Iva Holmerová, Ida J Korfage, Jenny T van der Steen

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Abstract

Advance care planning (ACP) is increasingly recognised in the global agenda for dementia care. The European Association for Palliative Care (EAPC) Taskforce on ACP in Dementia aimed to provide recommendations for policy initiatives and future research. We conducted a four-round Delphi study with a 33-country panel of 107 experts between September, 2021, and June, 2022, that was approved by the EAPC Board. Consensus was achieved on 11 recommendations concerning the regulation of advance directives, equity of access, and dementia-inclusive approaches and conversations to express patients' values. Identified research gaps included the need for an evidence-based dementia-specific practice model that optimises engagement and communication with people with fluctuating and impaired capacity and their families to support decision making, while also empowering people to adjust their decisions if their goals or preferences change over time. Policy gaps included insufficient health services frameworks for dementia-inclusive practice. The results highlight the need for more evidence and policy development that support inclusive ACP practice models.

Original languageEnglish
Pages (from-to)e370-e378
Number of pages9
JournalThe Lancet. Healthy longevity.
Volume5
Issue number5
Early online date9 Apr 2024
DOIs
Publication statusPublished - May 2024

Bibliographical note

Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

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