Developing a care pathway for advance decisions and powers of attorney: qualitative study

Background The Mental Capacity Act for England and Wales empowers individuals to plan ahead for when they may lack capacity. Aims to develop a care pathway for advance decisions and powers of attorney using Huntington's disease as an exemplar. Method Qualitative study Using in depth individual interviews with service users and carers, and focus groups with professionals. inductive qualitative analysis was used to develop themes to construct a care pathway that was then piloted and further evaluated to achieve a final pathway. Results A care pathway was developed that incorporated an early introduction through a formal education session and a minimum of two sessions separated by at least 2 weeks before advance decision completion. optimal delivery of this intervention requires significant clinical and administrative commitment. Conclusions We have developed a simple, easy-to-follow care pathway that was acceptable to users and providers.