Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study

Dementia (London). 2014 Jan;13(1):79-95. doi: 10.1177/1471301212449408. Epub 2012 Jul 2.


Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

Keywords: African Americans; advance care planning; dementia caregivers.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Advance Care Planning*
  • African Americans / education
  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Resuscitation / education
  • Caregivers
  • Chicago
  • Decision Making*
  • Dementia / nursing*
  • Enteral Nutrition
  • Feasibility Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Respiration, Artificial
  • Self Efficacy*
  • Terminal Care / methods*
  • Urban Health