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  4. Advance Directives in Long-Term Care: Implementation of Five Wishes
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Advance Directives in Long-Term Care: Implementation of Five Wishes

Full metadata

Title
Advance Directives in Long-Term Care: Implementation of Five Wishes
Description

Background and Purpose: The lack of an advance directive (AD) can predispose a person to an aggressive course of treatment despite their wishes. When AD’s are incomplete, the chances of unwanted procedures, such as tube feedings and repeated transitioning between nursing homes and hospitals often result in the risk of increased mortality and morbidity, especially for older adults. Making end-of-life decisions can improve the quality of death by allowing individuals to make decisions to die in a dignified manner. The purpose of this project was to improve AD completion rates by implementing “Five Wishes” (FW) into the admission process in a long-term care facility (LTCF).

Methods: The project took place on the skilled nursing units at a LTCF in Southwestern Arizona over a 2-month period of time. Twenty random charts were assessed before the start of the project to determine the residents AD status. Those 20 were then informed about FW’s and encouraged to complete one, along with all newly admitted residents to the skilled nursing units. Logs were used for data collection and each participating resident signed a HIPPA document. Descriptive statistics were used to describe the sample and outcome variables.
Outcomes Of the 20 current residents included in the quantitative chart assessment, 6 (30%) residents completed a FW’s document. Fifty residents were admitted during the project span and 21 (42%) of them completed FW’s.

Conclusions: The FW’s completion rates were lower than expected. None of the residents had an AD more detailed than a basic full code or do not resuscitate (DNR) status before being informed of FW’s. It is recommended that the facility social workers would have implemented the intervention to increase the likelihood of adherence.

Date Created
2018-05-04
Contributors
  • Mickey, Lexi L. (Author)
  • Johannah, Uriri-Glover (Thesis advisor)
Topical Subject
  • Advance Directives
  • Long-Term Care
Resource Type
Text
Extent
29 pages
Language
eng
Copyright Statement
In Copyright
Primary Member of
Doctor of Nursing Practice (DNP) Final Projects
Peer-reviewed
No
Open Access
No
Handle
https://hdl.handle.net/2286/R.I.48667
Level of coding
intermediate
Cataloging Standards
asu1
Collaborating institutions
College of Nursing and Health Innovation
System Created
  • 2018-05-15 02:50:39
System Modified
  • 2021-06-19 02:39:35
  •     
  • 3 years 10 months ago
Additional Formats
  • OAI Dublin Core
  • MODS XML

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