Background Ariadne Labs’ Serious Illness Care Program (SICP), inclusive of the Serious Illness Conversation Guide (SICG), has been adapted for use in a variety of settings and among diverse population groups. Explicating the core elements of serious illness conversations could support the inclusion or exclusion of certain components in future iterations of the programme and the guide. Aim This integrative systematic review aimed to identify and describe core elements of serious illness conversations in relation to the SICP and/or SICG. Design Literature published between 1 January 2014 and 20 March 2023 was searched in MEDLINE, PsycINFO, CINAHL and PubMed. All articles were evaluated using the Joanna Briggs Institute Critical Appraisal Guidelines. Data were analysed with thematic synthesis. Results A total of 64 articles met the inclusion criteria. Three themes were revealed: (1) serious illness conversations serve different functions that are reflected in how they are conveyed; (2) serious illness conversations endeavour to discover what matters to patients and (3) serious illness conversations seek to align what patients want in their life and care. Conclusions Core elements of serious illness conversations included explicating the intention, framing, expectations and directions for the conversation. This encompassed discussing current and possible trajectories with a view towards uncovering matters of importance to the patient as a person. Preferences and priorities could be used to inform future preparation and recommendations. Serious illness conversation elements could be adapted and altered depending on the intended purpose of the conversation.

To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures; while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models.

Background and Objectives: Thriving has been described as a multidimensional concept that can be used to explore place-related well-being; however, there has been limited research into the meaning of thriving in aged care. This study aimed to illuminate meanings of thriving as narrated by persons living in nursing homes.Research Design and Methods: Narrative interviews were conducted with 21 persons residing in a rural Australian nursing home. The interviews were audio-recorded, transcribed, and interpreted using a phenomenological hermeneutic approach.Results: Meanings of thriving could be understood as: Striving toward acceptance of being in a nursing home while maintaining a positive outlook; Feeling supported and cared for while maintaining a sense of independence; Balancing opportunities for solitude and company while living with others; and, Feeling a sense of home while residing in an institutional environment. The meanings of thriving, as presented through the interpretive lens of Gaston Bachelard’s “Poetics of Space,” encompassed having access to literal, metaphorical, and symbolic doors, as well as having the freedom to open, close, and use these doors however the person wishes.Discussion: Exploring meanings of thriving in nursing homes could contribute towards understanding and implementing positive life-world constructs in research and practice. These findings could be used to inform and enhance person-centered care practices by maximizing opportunities for persons residing in nursing homes to have options and choices, and the agency to make decisions where possible, in relation to their everyday care and living environment.

Serious illness conversations aim to align medical care and treatment with patients’ values, goals, priorities, and preferences. Timely and accurate identification of patients for serious illness conversations is essential; however, existent methods for patient identification in different settings and population groups have not been compared and contrasted. This study aimed to examine the current literature regarding patient identification for serious illness conversations within the context of the Serious Illness Care Program and/or the Serious Illness Conversation Guide. A scoping review was conducted using the Joanna Briggs Institute guidelines. A comprehensive search was undertaken in four databases for literature published between January 2014 and September 2021. In total, 39 articles met the criteria for inclusion. This review found that patients were primarily identified for serious illness conversations using clinical/diagnostic triggers, the ’surprise question’, or a combination of methods. A diverse assortment of clinicians and non-clinical resources were described in the identification process, including physicians, nurses, allied health staff, administrative staff, and automated algorithms. Facilitators and barriers to patient identification are elucidated. Future research should test the efficacy of adapted identification methods and explore how clinicians inform judgements surrounding patient identification.

Aim: To explore contributors for thriving in nursing homes by evaluating, analysing and synthesizing peer‐reviewed qualitative literature on the topic.Background: Thriving is a positive life‐world concept that has been explored by several qualitative studies; however, descriptions of thriving and contributors to thriving have not been compared or contrasted among different studies and contexts, nor have they been reviewed and synthesized.Design: Qualitative meta‐ethnography.Data sources: Four electronic databases were searched in October 2019, with sources published between 2000 and 2019 included.Review methods: Sources of peer‐reviewed literature that employed qualitative methods to explore thriving in nursing homes were evaluated. In total, 1,017 sources were screened at title‐level, 95 advanced to abstract‐level review and 11 were assessed at full‐text level. Each source was evaluated by two researchers independently in relation to methodological quality and relevance to the study aim. Themes pertaining to thriving in nursing homes were extracted, interpreted and synthesized.Results: In total, seven sources of peer‐reviewed literature were included. Two main themes illustrating the contributors to thriving were identified: ingredients for thriving (subthemes: personal contributors and social contributors) and environment for thriving (subthemes: spacial contributors and societal contributors).Conclusion: Contributors to thriving in nursing homes include personal attributes, relationships with others, the lived environment and societal structures. Thriving for older people could thereby be defined as a holistic concept denoting lived experiences of situated contentment. Future studies should explore different temporal facets of thriving in the nursing home setting.Impact: This meta‐synthesis proposes a ‘recipe’ for thriving as comprising the right ingredients and the right environment, determined by the preferred ‘taste’ of the individual person. The proposed definition and contributors illuminate thriving as a positive life‐world concept that is based on one's lived experiences and context.