Advance Care Planning: Community Education to Improve End-of-Life Knowledge and Communication

Abstract

The research and development of new technologies within modern medicine allow patients to live longer with chronic diseases. For some patients, quantity of life does not always equal quality of life and may increase suffering at the end-of-life (EOL). Advance Care Planning (ACP) and EOL discussions amongst family members and medical providers can contribute to patient’s experiencing a more peaceful death. Despite the benefits of ACP, only 30% of United States citizens have documented their EOL wishes. The purpose of this project was to improve comfort levels discussing EOL preferences; and increase participant knowledge and willingness to complete ACP documents. Utilizing a quality improvement design, participants were recruited from a 55 and older bible study group at Mission Community Church, and neighboring churches in Gilbert, Arizona. The three-hour educational seminar included a combination of ACP education, and the EOL communication game Hello. Data was obtained from pre-educational and post-educational surveys which included the ACP Engagement Survey. This was used to identify baseline and post-education stage of change, based on the Transtheoretical Model. Significant changes were found within three out of the nine questions on the ACP Engagement Survey. This included participants’ readiness to communicate with their healthcare provider whom their appointed medical power of attorney (MPOA) is: pre- (M=3, SD 1.60); post- (M=3.75, SD 0.8864); t= 2.393, p= 0.047; readiness to document their EOL wishes: pre- (M= 2.875, SD 1.126); post- (M= 4.0, SD 0.5345); t= 3.211, p= 0.0148; readiness to sign documents appointing a MPOA: pre- (M=3.0, SD 1.195); post- (M= 3.625, SD 0.9161); t= 2.376, p= 0.0492). Extremely significant findings were obtained from the overall ACP Engagement survey: pre- (M= 3.431, SD 0.5698); post- (M= 4.125, SD 0.6409); t=6.799, p = 0.0001). Participants believed the information that they received during the seminar improved their comfort levels discussing EOL wishes, and ACP knowledge. Despite low attendance (N=8), there is significant evidence to support ACP community education and the EOL communication game Hello, does improve knowledge and comfort levels in discussing EOL preferences. Further research should include studies with multiple educational seminars, and/or larger scale study.