Effect of life autonomy programs on engaging in advance care planning and end-of-life care decisions for people with mild cognitive impairment and their family caregiver

Objectives: Exploring the effect of a life autonomy program on the engagement in advance care planning (ACP) and end-of-life (EoL) care decisions among people with mild cognitive impairment (PWCIs) or mild dementia and among their family caregivers (FCGs). Methods: A one-group, pretest-posttest design was applied. The inclusion criteria for PWCIs were: aged >55 years, had a diagnosis of mild dementia or mild cognitive impairment, and had never participated in a formal ACP consultation. Their FCGs also must have agreed to participate in the study. The intervention was provided by an ACP-trained registered nurse. A structured questionnaire was used for data collection, and paired t tests and the intraclass correlation coefficient were used to compare the differences between pre-intervention and post-intervention. Results: A total of 44 dyads of participants completed this study. After the intervention, both PWCIs and their FCGs had significantly greater knowledge of end-stage dementia treatment and ACP (p c.Ol). PWCIs were significantly more likely to sign advance directives for palliative care (p <.05) and for a health care agent (p <.05). FCGs were also significantly more likely to sign do not resuscitate consent forms for PWCIs (p <.05). The consistency of EoL care decisions also increased between PWCIs and FCGs after intervention. Conclusions: Life autonomy programs significantly and positively affect the PWCIs' and FCGs∗ consideration of EoL care decisions. We suggest for care teams to recognize the equality of and accessibility to ACP for this PWCIs, promote the communication and discussion of ACP as soon as possible, and improve the quality of EoL care for PWCIs.