P-31 Examining how advance care directives are used for individuals with dementia living in residential accommodation: A literature review
Bibliographic record
Abstract
Background Advance Care Directives (ACDs) have undergone the greatest development in the United States, Australia and Canada but are less developed in Europe. There are now global initiatives supporting end of life wishes with the World Health Organisation suggesting such individuals require integrated care, which supports choice and autonomy. Aims The aim of this study was to understand and explain how Registered Nurses use ACDs for individuals with dementia living in residential accommodation, relating to: (i) introduction of ACDs; (ii) completion of ACDs and (iii) adherence to ACDs for individuals with dementia living in residential accommodation. Design This study involved selection of literature relevant to addressing the study objectives. A systematic search of academic and grey literature databases was undertaken to locate international studies addressing the study objectives. Also the study employed a network approach where manual searching of the electronically retrieved sources was performed to identify relevant references. Findings There was: (i) reduced uptake of ACDs; (ii) reduced hospital transfers and costs; (iii) improved psychological well-being of family members and (iv) satisfaction with care and quality of life. Discussion ACDs enable persons with dementia to participate in decision making for their future care long after losing capacity to do so. This is pertinent since many older individuals are actually very interested in end of life decision-making. Conclusion There was a scarcity of high quality evidence evaluating the use of ACDs with individuals with dementia. Further research is recommended on the content of ACDs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.051 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.016 | 0.017 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".