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Survey feedback highlighted ambiguities: raising end-of-life issues may cause emotional harm, while excessive caution may miss opportunities to elicit preferences. Panelists recommended tailored, person-centered approaches, scenario-based dialogue, attitude probing, and offering choices to reduce harms and lower barriers to initiating ACP.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/ambiguities-about-discussing-end-of-life-in-the-context-of-advance-care-planning-in-dementia/422202/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/ambiguities-about-discussing-end-of-life-in-the-context-of-advance-care-planning-in-dementia/422202.png","ImageObject",300,407,{"name":42,"@type":43},"Mary 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discussions?",{"text":72,"@type":64},"Panelists proposed tailored, person-centered approaches, including sketching realistic future scenarios, probing attitudes, and offering choices.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},422202,1790766402,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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ABOUT DISCUSSING END OF LIFE IN THE CONTEXT OF ADVANCE CARE PLANNING IN DEMENTIA  \nJenny van der Steen1, Lieve Van den block2, Miharu Nakanishi3, Jürgen in der Schmitten4, Rebecca L. Sudore5, and Ida J. Korfage6, 1. Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands, 2. Vrije Universiteit Brussel, Brussels, Brussels Hoofdstedelijk Gewest, Belgium, 3. Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan, 4. Universitätsklinikum Essen, Essen, NordrheinWestfalen, Germany, 5. University of California, San Francisco, San Francisco, California, United States, 6. Erasmus University Medical Center, Rotterdam, Zuid-Holland, Netherlands  \nAdvance care planning (ACP) in dementia has been defined asa communication process adapted to the person’s capacity, which includes, and is continued with family, in our European Association  \n766 Innovation in Aging, 2025, Vol. 9, No. S2  \nfor Palliative Care Delphi study Delphi study with an expert panel from 33 countries. A consensus was achieved that ACP discussions can refer to the end of life, but it is not a requirement. The study comprised four survey rounds and offered ample room for qualitative feedback. The feedback indicated ambiguity around discussing the end of life in the context of ACP. Regardless of a consensus-according to conservative criteria-to offer ACP around dementia diagnosis and to raise end-of-life issues later, there were concerns that bringing up the end of life could cause emotional harm to the person with dementia and the family. The panelists suggested that adopting a tailored, person-centered approach to ACP could help prevent such harms. On the other hand, there were concerns that being too careful could result in missed opportunities to talk about the end of life and elicit the persons’ preferences when still able. Sketching a realistic scenario of the future and its uncertainties, probing attitudes ofthe person and their family, and offering choices may prevent possible detrimental effects of initiatingACP and discussing the end of life even early on. Taking such an individualized approach is consistent with the understanding of ACP as part of a process rather than a one-time event and may lower barriers to initiate ACP.","cbCainenlhZpY4rG","https://ap.wps.com/l/cbCainenlhZpY4rG","pdf",1351257,"English","# Abstract\n## Delphi consensus and requirements\n## Ambiguities and potential harms\n## Person-centered strategies for dialogue","[{\"question\":\"What does the study say about end-of-life discussion within ACP for dementia?\",\"answer\":\"The panel reached consensus that ACP discussions can refer to end of life, but it is not a requirement.\"},{\"question\":\"What ambiguities were reported regarding discussing end of life in ACP?\",\"answer\":\"Feedback indicated uncertainty about when and how to raise end-of-life issues, including concerns about emotional harm versus the risk of missing opportunities to elicit preferences.\"},{\"question\":\"How did the panel suggest reducing risks when initiating ACP discussions?\",\"answer\":\"Panelists proposed tailored, person-centered approaches, including sketching realistic future scenarios, probing attitudes, and offering choices.\"}]","AMBIGUITIES ABOUT DISCUSSING END OF LIFE IN THE CONTEXT OF ADVANCE CARE PLANNING IN DEMENTIA | PDF",1790626483]