A Rapid Review of Advance Care Planning Interventions, Strategies, and Communication Approaches in Dementia Care

Abstract Advance care planning is essential for aligning future care with the values and preferences of people living with dementia and their families. Challenges from people with dementia’s fluctuating mental capacity, gradual decline and healthcare professional’s limited advance care planning knowledge and skills remain to enable people with dementia to fully engage with the process; tailored interventions are needed. This rapid review synthesised evidence on advance care planning interventions, communication strategies and health-related outcomes in dementia care. Following Cochrane’s guidance for rapid reviews, we searched CINAHL, Cochrane Central, PubMed, and Web of Science through May 2025. After duplicate removal, title-abstract and full-text screening were conducted in Covidence with dual independent reviewers. Data extraction and quality assessment, using Joanna Briggs Institute tools, employed a single-reviewer approach with verification by second reviewer. Twenty-five studies from 2015–2025 across 12 countries met inclusion criteria. Included articles were of quantitative designs (n=15), qualitative (n=5) and mixed methods (n=4). Interventions fell into three categories: video as decision aids; web-based tools; and multicomponent programmes combining education, structured discussions, and documentation support for people with dementia, families and healthcare professionals. Primary outcomes consistently showed increased advance care planning uptake. Certain secondary outcomes—carer burden, cost of care, carer’s sense of competence, hospitalisation rates, quality-adjusted life year, quality of life of people with dementia, rate of burdensome treatments—demonstrated mixed results. Communication strategies identified included embedding relevant theories such as relational autonomy and shared decision-making frameworks for advance care planning process. Study quality ranged from poor (n=8) to high (n=6). Common limitations include small sample sizes, unclear randomisation and allocation processes and limited reflexivity in qualitative research. These findings suggest that contextually tailored advance care planning interventions improve uptake but require standardised outcomes and broader cultural adaptation to comprehensively assess impacts on health outcomes. Competing Interest Statement The authors have declared no competing interest. Clinical Protocols https://www.crd.york.ac.uk/PROSPERO/view/CRD420251034120 Funding Statement The author(s) received no financial support for the research, authorship, and/or publication of this article. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript