An Integrative Healthcare Approach to Empowering Older Adults in Creating Advance Directives

The purpose of this study is to determine the best practice strategies for creating advance directives when using an integrated team approach. Healthcare professionals are required to inform nursing home residents of their rights around advance directives. Healthcare professionals are also called to assist nursing home residents in creating an advance directive, without coercion, so that it reflects their values around death and dying. Six healthcare professionals (consisting of four social workers, one nurse, and one chaplain) were interviewed to determine their beliefs about the integrative team approach to creating advance directives. The qualitative interviews were analyzed from a grounded theory approach. The ecological perspective for healthcare social workers was used to further conceptualize the data. This study found that having early and frequent discussions with the patient and their family was essential to creating an advance directive. Finding healthcare professionals who are confident and comfortable with talking about death and dying is also beneficial in advance directive discussions. Having an agency that values holistic approaches to healthcare equated to valuing integrative team approaches when discussing advance directives. This study concludes that implementing advance directive strategies with integrative team work remains an abstract theory that lacks evidence of use between these two approaches. Based on the responses around strategies to create advance directives and how integrated teams work together it would appear that the integrative approach to creating advance directives would be successful in accurately documenting the patient’s values and wishes around death and dying