Citation link: http://dx.doi.org/10.25819/ubsi/10319
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Dokument Type: Article
metadata.dc.title: Project DECIDE, part 1: increasing the amount of valid advance directives in people with Alzheimer’s disease by offering advance care planning - a prospective double-arm intervention study
Authors: 
Institute: Fakultät V - Lebenswissenschaftliche Fakultät 
Free keywords: Dementia, Alzheimer’s disease, Memory clinic, Advance directive, Patient empowerment, Advance care planning, Autonomy, Supported decision making
Dewey Decimal Classification: 610 Medizin, Gesundheit
GHBS-Clases: VYC
VUE
VURE
QSA
Issue Date: 2022
Publish Date: 2023
Source: BMC medical ethics ; 23, article number 132. - DOI: https://doi.org/10.1186/s12910-022-00854-0
Abstract: 
Background
Everybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.
Method
We intend to recruit at least N = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.
Discussion
The results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.
Description: 
Finanziert im Rahmen der DEAL-Verträge durch die Universitätsbibliothek Siegen
DOI: http://dx.doi.org/10.25819/ubsi/10319
URN: urn:nbn:de:hbz:467-25128
URI: https://dspace.ub.uni-siegen.de/handle/ubsi/2512
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