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Cultural and Institutional Considerations in Advance Care Planning in Long-Term Care Settings

机译:在长期护理环境中提前关注规划的文化和制度考虑

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摘要

Advance Care Planning (ACP) is a process that supports individual’s understanding and sharing of personal values, life goals, and preferences regarding future medical care, so that they obtain care consistent with these during serious and chronic illness. While ACP is important for all, it is especially so for people who fall outside traditional, western, heteronormative contexts (e.g. who belong to ethnic, racial and/or sexual/gender minorities). This symposium draws from research conducted by the Diversity Access Team [part of a national project iCAN-ACP Improving Advance Care Planning for Frail Elderly Canadians]. The first paper presents results from focus groups conducted with loved ones of South Asian, Chinese and Lesbian, Gay, Bisexual, and Transgender (LGBT) older adults living in care homes; issues identified as barriers include starting ACP conversations too late (“my husband has severe dementia”), lack of consideration of cultural traditions and, in the case of LGBT older adults, their non-family support networks. The second paper draws from focus groups with care home staff, implicating their own training as a barrier to assisting residents/families with ACP as well as resident, family, institutional and cultural influences. A third paper reports on an educational intervention designed to increase staff understanding of ACP and comfort in assisting residents/families with ACP. The fourth paper reports feedback received on two ACP planning tools, reflecting the importance of minority group representation in visuals and text. Together, these papers underscore the importance of taking culture into consideration in framing and discussions of fostering ACP among minority populations.
机译:提前关怀规划(ACP)是一个支持个人理解和分享个人价值观,生命目标和偏好的过程,以便在严重和慢性疾病期间获得与这些保持一致。虽然ACP对所有人都很重要,但对于落在传统,西方,异教徒环境(例如属于种族,种族和/或性/性别少数群体)的人来说,特别是尤其如此。该研讨会从多样性访问团队[部分项目ICAN-ACP的一部分改善脆弱年长加拿大人的预先关心规划]进行的研究。第一篇论文介绍了与南亚,中国和女同性恋,同性恋,双性恋,双性恋和跨性别(LGBT)的老年人在护理家庭中进行的焦点小组的结果;确定为障碍的问题包括起始的ACP对话太晚(“我的丈夫有严重痴呆症”),缺乏对文化传统的思考,并在LGBT老年人的情况下,他们的非家庭支持网络。第二张纸从带有护理家庭工作人员的焦点小组绘制,将自己的培训视为协助居民/家庭以及居民,家庭,制度和文化影响的障碍。关于教育干预的第三篇论文报告,旨在提高对ACP的员工了解和舒适的辅助居民/家庭。第四篇论文报告了两项ACP规划工具中收到的反馈,反映了少数群体群体在视觉效果和文本中的重要性。这些论文在一起强调了在少数民族人群中讨论框架和讨论框架的思考的重要性。

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