86 How the past and the dead inform the living and their future care

<h3></h3> The aim of this presentation is to promote an alternate approach to advance care planning (ACP) that connects with a disengaged cohort, namely, aged people living in the community that are neither terminal or palliative but experience the morbidity and mortality challenges of ageing. I am the primary care person of aged parents living in community, and have worked as a clinical aged care nurse for most of my career. I am frequently confronted by the denial and lack of planning for the health challenges and end point – death – this aged cohort inevitably experiences. I have directly observed a lack of engagement by this cohort in ACP unless faced with a health crisis, which I believe is primarily due to their low levels of health and death literacy. In my current role with Ageing Australia in the End-of-Life Directions in Aged Care Project, I endeavor to promote the integration of alternate, creative and novel approaches to ACP that compliment contemporary methods. A narrative approach to ACP is a safe and gentle entry point into understanding the aged persons thinking around future care and end-of-life, based on their prior experience, behavior, attitudes and exposure to illness, dying and death. Life narratives allow the practitioner to deeply explore the influence of the past on the aged person’s current goals, preferences, values and beliefs. It provides space for the aged person to reflect and make meaning of their lived experience in the context of their future care expectations. A narrative approach enables the practitioner to determine the level of health and death literacy, or lack thereof, and to increase awareness and literacy where appropriate. Specifically, death literacy is found to be a critical resource for empowering the aged person to make informed care and end-of-life decisions. ACP is often a sensitive and complex issue for this cohort for several reasons, and therefore to increase the uptake of ACP, alternate approaches to the current ACP tools and practices should be considered. A narrative approach gleans deeper and richer information than current ACP questions permit and provides an opportunity to increase death literacy through exploration and reflection. Listening to the person’s story creates a genuine and trusting relationship which is advantageous for ongoing ACP reviews. Greater uptake of ACP will empower this cohort to prepare and make informed decisions for their inevitable natural decline, external to a crisis or terminal event.