P-09

Background, relevance and purpose

Professionals are hesitant of initiating advance care conversations with patients with dementia and their relatives. This study aimed at developing and evaluating a conversation tool that supports primary healthcare professionals, in engaging conversations about patients’ wishes and preferences for future issues.

Methods

First we developed a conversation tool, based on (1) relevant literature (2) semi-structured interviews with 9 people with dementia, 9 relatives, and 4 general practitioners (GP), and (3) two focus group interviews with case managers dementia (CD). Secondly, we evaluated the conversation tool in a pilot study. Therefore three GPs, three geriatricians and 18 CD used the tool in daily practice after receiving an instructional video. Twelve of them participated in two reflection meetings to support the implementation. Semi-structured interviews were held with the professionals as well as the people with dementia and their relatives who received the intervention. We applied thematic data-analyses with Atlas.ti.

Results

Six relevant conversations topics were elicited: (1) daily enjoyment, (2) daily care, (3) medical treatment, (4) coping with the dementia and the (nearing) death, (5) financial and legal issues, and (6) the social network. The topics were incorporated in the tool. Preliminary results from the evaluation: professionals indicate the conversation tool provides structure and support in planning and starting conversations. There is variety in the manner of use. The topics were recognizable and appropriate, though professionals also formulated recommendations regarding content and lay-out of the tool. Long term experiences will be presented at the congress.

Conclusion

Advance care planning in the context of dementia includes issues related to the daily life, and medical and legal issues. The conversation tool provides structure and a visual overview of the important topics, and can be used flexibly. The content and lay-out requires small adjustments. With research fellows we would like to discuss how we can adjust the tool in a digital format.