Understanding how advance care planning is approached in the residential aged care setting: A continuum model of practice as an explanatory device

Objective: To gain an understanding of how advance care planning (ACP) is understood and approached by managers of residential aged care facilities. Methods: Qualitative interviews with managers from 41 residential aged care facilities from South Western Sydney, Australia. Content and thematic analysis of interview transcripts. Results: The majority of facilities do not have a systematic approach to ACP, but tend to initiate discussions about end‐of‐life treatments late in a resident's illness. There are varying degrees to which these discussions are used in ongoing care planning or made explicit if the resident is transferred to hospital. A number of factors are identified that support the implementation of ACP. Conclusion: A continuum model of practice is proposed that describes four broad approaches to practice under the domains of initiation, scope, follow‐up and documentation of ACP as well as the organisational leadership adopted around ACP.