000167867 001__ 167867
000167867 005__ 20260121151420.0
000167867 0247_ $$2doi$$a10.3390/jcm15010214
000167867 0248_ $$2sideral$$a147547
000167867 037__ $$aART-2025-147547
000167867 041__ $$aeng
000167867 100__ $$aSánchez Ortiz, Miguel
000167867 245__ $$aAdvance Care Planning and Frailty in Nursing Homes: Feasibility and Acceptance of a Stepwise, Long-Term Care, Structured Model
000167867 260__ $$c2025
000167867 5060_ $$aAccess copy available to the general public$$fUnrestricted
000167867 5203_ $$aBackground/Objectives: Population aging in Europe presents significant healthcare, economic, and social challenges, particularly in the care of individuals with chronic diseases and frailty. Advance Care Planning (ACP) fosters patient autonomy and aligns end-of-life care with individual preferences. This study aimed to evaluate the acceptability and feasibility of an ACP model in nursing homes. Secondary objectives included exploring clinical characteristics of participants and assessing how frailty is associated with residents’ care goals and preferences. Methods: A prospective observational study was conducted among long-term residents of a Spanish nursing home in 2023. ACP was offered to all new permanent residents, with outcomes assessed through quarterly follow-ups. Acceptance rates, care preferences, and resident satisfaction were primary measures. Clinical data, frailty, functional status, cognitive assessments, and nutritional status were analyzed. The model of ACP is structured into three progressive levels: (1) identification of patients’ values, preferences, and global goals of care; (2) decision-making regarding specific clinical interventions in acute situations; and (3) end-of-life care preferences, including preferred place of death, desired companionship, and comfort-focused measures. Results: From 79 new residents admitted, 93.7% accepted ACP. The process required an average of 139 min to complete, distributed over 3–4 sessions. The main documented preferences included do-not-resuscitate orders (CPR) (79%), hospital transfer decisions (50%), and other individualized care choices. When stratified by frailty level, which was categorized as low, moderate, or high—we observed a clear gradient in care preferences. CPR preference increased from 59.3% (Low) to 87.5% (Moderate) and 95.2% (High). Preference to avoid hospital transfer rose from 22.2% to 50.0% and 85.7%, respectively. Avoidance of instrumentalization increased from 56.2% to 85.0% and 95.0%. Conclusions: ACP in nursing homes is highly acceptable and feasible, with benefits in aligning care with patient preferences and enhancing satisfaction.
000167867 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000167867 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000167867 700__ $$aForcano Garcia, Mercedes
000167867 700__ $$0(orcid)0000-0002-9678-9688$$aAltisent Trota, Rogelio$$uUniversidad de Zaragoza
000167867 700__ $$aRocafort Gil, Javier
000167867 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000167867 773__ $$g15, 214 (2025), 1-12$$pJ. clin.med.$$tJournal of Clinical Medicine$$x2077-0383
000167867 8564_ $$s846254$$uhttps://zaguan.unizar.es/record/167867/files/texto_completo.pdf$$yVersión publicada
000167867 8564_ $$s2501785$$uhttps://zaguan.unizar.es/record/167867/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000167867 909CO $$ooai:zaguan.unizar.es:167867$$particulos$$pdriver
000167867 951__ $$a2026-01-21-14:55:16
000167867 980__ $$aARTICLE