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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Science (DNS)


advance care planning, quality of life, long-term care, end-of-life (EOL), good death


Introduction: The nation’s population is aging; many older adults may soon need longterm care (LTC) for their daily needs up to and through end-of-life (EOL). LTC residents value open and direct dialog with healthcare providers about their EOL preferences and decision making. Moreover, most LTC residents value quality of life (QOL) over quantity. Advance care planning (ACP) in the LTC setting is underused, and individualized goal centered EOL care is inconsistent. Providing ACP opportunities for LTC residents is critical to promoting preferred EOL care for this population.
Methods: Using the search words advance care planning, quality of life, long-term care, end-of-life, and good death, databases were searched for scholarly articles published in English within the past 5 years. Thirty-five initial articles were located; 24 met inclusion criteria and were included as evidence for this project.
Gaps: There is little evidence of the impact of ACP on QOL at EOL in LTC residents. Further work is required in the rural LTC environment to determine ACP best practices and its impact on EOL care.
Recommendations for Practice: ACP dialogue and plans of care should include residents’ EOL care, as well as address notions of dignity, compassion, and spirituality. Further exploration is required to determine the impact of ACP on QOL and to determine ACP best practices.

Library of Congress Subject Headings

Advance directives (Medical care)
Terminal care.
Quality of life.

Number of Pages



South Dakota State University


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