private room in a nursing home

A new report looks at what’s working to help residents in long-term care communities prioritize care planning and advanced care planning, or ACP.

The study was published on Dec. 6 in The Journal of Long-Term Care. Researchers set out to look at studies and surveys on care planning interventions for older adults in long-term care communities. The team wanted to understand what types of programs are being used to drive better care planning overall.

Care planning focuses on residents’ current circumstances while ACP centers on sharing preferences for future care decisions. The team pared down hundreds of studies and focused on evaluating 112 eligible articles. Most of the reports are of initiatives that took place in the United States, Australia and the UK in nursing homes. More than 90% of the interventions were aimed at staff training, and one was on training staff that don’t directly interact with residents (like food workers). About one-third of the studies involved family members and friends, and 62% detailed interventions to improve care planning practices.

Though there are benefits of ACP in particular, a lot of evidence showed that many people living in long-term care communities do not have ACP. Also, most interventions require training to educate staff. Though that works, high staff turnover can be an issue, as it’s been associated with a low uptake in ACP as well. Another highlight of the paper was the use of digital care planning, which became more popular in the pandemic.

Largely, ancillary workers and family and friends — people who could play a valuable role in care planning —  were often not included in the care planning interventions. That’s where research should focus in the future, the authors said.
“The absence of this information makes it difficult to recommend specific interventions to policymakers and practitioners due to resource and workforce implications being unclear. It is also unclear whether certain interventions will be suitable for care home residents with dementia,” the authors noted. “A clear reporting framework is needed to address these gaps in our understanding of care planning interventions.”