Understanding how advance care planning is approached in the residential aged care setting: a continuum model of practice as an explanatory device

Australas J Ageing. 2009 Dec;28(4):211-5. doi: 10.1111/j.1741-6612.2009.00383.x.


Objective: To gain an understanding of how advance care planning (ACP) is understood and approached by managers of residential aged care facilities.

Methods: Qualitative interviews with managers from 41 residential aged care facilities from South Western Sydney, Australia. Content and thematic analysis of interview transcripts.

Results: The majority of facilities do not have a systematic approach to ACP, but tend to initiate discussions about end-of-life treatments late in a resident's illness. There are varying degrees to which these discussions are used in ongoing care planning or made explicit if the resident is transferred to hospital. A number of factors are identified that support the implementation of ACP.

Conclusion: A continuum model of practice is proposed that describes four broad approaches to practice under the domains of initiation, scope, follow-up and documentation of ACP as well as the organisational leadership adopted around ACP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Advance Care Planning*
  • Aged
  • Homes for the Aged*
  • Humans