End-of-Life Care Planning: Perspectives of Returning Citizens.
Erin Kitt-Lewis, Susan J Loeb
PMID 37962113WHAT IT FOUND
Formerly incarcerated adults described end-of-life care planning in prison as blocked by mistrust and lost autonomy.
They wanted clear, respectful conversations early, written plans, trusted messengers, and access to records.
Key findings
01Most participants were not familiar with advance directives or advance care planning.
02Participants identified lack of autonomy, lack of trust, lack of credible resources, treatment by staff, and risk versus benefit as barriers to end-of-life care planning.
03They suggested end-of-life care planning discussions should use straightforward, respectful, positive language and should protect trust and confidentiality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Sixteen participants is small, and the study asks for perspectives rather than testing whether an end-of-life care planning toolkit changes care. Participants were formerly incarcerated adults, not people currently in prison, so their recollections may not match current prison conditions. The study was changed because of the pandemic, and recruitment relied on flyers and networks, so it may not represent all returning citizens. Most participants were unfamiliar with advance directives or advance care planning, so their definitions varied. The paper reports no patient outcomes, mortality, symptom control, or completion of advance directives.
Declared interests
The supplied text does not include an author conflict-of-interest declaration. The publication types note NIH extramural research support.
The easy way to misread this
Do not read this as evidence that an end-of-life care planning toolkit works. It reports the perspectives of 16 formerly incarcerated adults and does not test an intervention or patient outcomes.