Abstract
Background
The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is an advance care planning process designed to facilitate discussion and documentation of preferences for care in a medical emergency. Advance care planning is important in residential and nursing homes.
Aim
To explore the views and experiences of GPs and care home staff of the role of ReSPECT in: a) supporting, and documenting, conversations about care home residents’ preferences for emergency care situations, and b) supporting decision-making in clinical emergencies.
Setting/ Participants
Sixteen GPs providing clinical care for care home residents and 11 care home staff in the West of England.
Methods
A qualitative research design using semi-structured interviews.
Results
Participants’ accounts described the ReSPECT process as facilitating person-centred conversations about residents’ preferences for care in emergency situations. The creation of personalised scenarios supported residents to consider their preferences. However, using ReSPECT was complex, requiring interactional work, management of tensions between medical recommendations and resident or relative preferences, and translation of preferences into action in emergency situations. Care staff played an important role in facilitating and supporting ReSPECT conversations and in translating it into action.
Conclusions
The ReSPECT process in care homes was positive for GPs and care home staff. We highlight challenges with the process, communication of preferences in emergency situations and the importance of balancing detail with clarity. This study highlights the potential for a multi-disciplinary approach engaging care staff more in the process.
The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is an advance care planning process designed to facilitate discussion and documentation of preferences for care in a medical emergency. Advance care planning is important in residential and nursing homes.
Aim
To explore the views and experiences of GPs and care home staff of the role of ReSPECT in: a) supporting, and documenting, conversations about care home residents’ preferences for emergency care situations, and b) supporting decision-making in clinical emergencies.
Setting/ Participants
Sixteen GPs providing clinical care for care home residents and 11 care home staff in the West of England.
Methods
A qualitative research design using semi-structured interviews.
Results
Participants’ accounts described the ReSPECT process as facilitating person-centred conversations about residents’ preferences for care in emergency situations. The creation of personalised scenarios supported residents to consider their preferences. However, using ReSPECT was complex, requiring interactional work, management of tensions between medical recommendations and resident or relative preferences, and translation of preferences into action in emergency situations. Care staff played an important role in facilitating and supporting ReSPECT conversations and in translating it into action.
Conclusions
The ReSPECT process in care homes was positive for GPs and care home staff. We highlight challenges with the process, communication of preferences in emergency situations and the importance of balancing detail with clarity. This study highlights the potential for a multi-disciplinary approach engaging care staff more in the process.
| Original language | English |
|---|---|
| Article number | afac226 |
| Number of pages | 8 |
| Journal | Age and Ageing |
| Volume | 51 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 23 Oct 2022 |
Bibliographical note
Publisher Copyright:© 2022 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society.
Research Groups and Themes
- NIHR ARC West
Keywords
- Advance Care Planning
- ReSPECT
- Qualitative Research
- Nursing Homes
- Primary Health Care