Improving Primary Care Clinicians' Communication Skills in Dementia-Related Advance Care Planning

• Describe the characteristics of the novel training session to improve communication skills in ACP for persons with ADRD.• Categorize the different ACP needs at different stages of ADRD including contrasting communication skills important to early versus later stages of ADRD.• Practice key communication skills in Dementia-Related Advance Care Planning. Primary care clinicians (PCPs) in the United States lack communication skills in advance care planning (ACP) for persons with dementia. Most ACP communication training fails to address the roll of the caregiver across the dementia process. Attendees should learn about a novel training session to improve communication skills in advance care planning for persons with dementia. To improve dementia-specific ACP-focused communication skills for PCPs we developed a 4-hour training session with sections devoted to the major stages of dementia. 1) advance directives in early dementia, 2) decision-making capacity in moderate dementia, 3) using the “Physician Orders for Life-Sustaining Treatment” in late dementia, and 4) hospice and hospitalization in advanced dementia. Each session included didactics, video scenarios, participant role-playing, and an action plan to implement communication skills. Participants’ confidence in key dementia ACP skills were analyzed by comparing their ratings before and after the training using Wilcoxon signed-rank test. We trained 51 participants; most were women (n=42), white (n=37), and physicians (n=31). Post-training, participant confidence increased in determining capacity, exploring dementia prognosis, exploring goals of care (GOC), eliciting proxies, recommending self-care practices to families, leading family meetings about GOC, and leading family meetings about hospice, (p<0.001 for all pre-post comparisons). Most participants strongly agreed that the training addressed skills used in their practice (n=34), contained clear language (n=40), took an appropriate amount of time (n=32), and was designed effectively (n=35). This training increased PCP’s confidence in their dementia-specific ACP focused communication skills. It was positively evaluated by participants as useful, clear, timely, and effective.