Advancing older persons autonomy through advance care planning, the role for gerontological social workers

This study set out to explore the concept of advance care planning (ACP) in an Older Persons’ Mental Health Service in Dublin, Ireland, from the perspective of healthcare professionals, older people, and their family carers, using a three-stage mixed-method participatory action research approach. The study is underpinned conceptually by critical gerontology, which offers a lens to promote and uphold older persons’ human rights and to consider how health inequalities are perpetuated at a societal level and affect their participation. Prior research indicates that whilst ACP is largely recognized as maintaining autonomy, uptake remains low, and there are challenges with implementation. The five themes identified were the importance of fostering and upholding autonomy, time and timing, balancing the voice of the older person and family carer, taking a life course approach, and gerontological social workers as leaders in ACP. The study amplifies the centrality of gerontological social workers’ role in advancing older persons’ autonomy through ACP. The implications for social work practice identified include a leadership role in complex cases at the upper tier, taking an active stance to target resources for socially isolated older persons, the development of a life course approach, and addressing micro and macro barriers.