IAGG 2017 World Congress to burnout and grief suggesting that support from cowork- ers may not necessarily be protective against the negative impacts of resident death, but instead may increase distress. OUTCOMES OF ADVANCE DIRECTIVES AND DURABLE POWER OF ATTORNEY AT END-OF-LIFE D. Hoe, S. Enguidanos, Gerontology, University of Southern California, Los Angeles, California Studies show that individuals at end-of-life (EOL) are more likely to have advance directives (AD) or a durable power of attorney (DPA). However, most of these studies do not investigate the outcomes of decision-making at EOL. This paper examines the association between individuals with ADs and DPAs and the care received by those individu- als, and it compares the appointed decision maker to the actual decision maker at EOL. The study will use a nation- ally representative sample from the Health and Retirement Study (HRS) Core and Exit interviews conducted between 2008 and 2014, and it will compare its fndings to those of Silveira, Kim & Langa (2010). Analysis was conducted on data compiled from 5,000 participants age 60 and older and from proxies following participant death. 45.8% of decedents required decision- making, of whom 69.3% lacked decision-making capacity. About half (51.0%) of these decedents had advance direc- tives and 68.3% had a DPA. However, there was only 15.1% agreement between the appointed decision maker and the actual decision maker. Logistic regression revealed that par- ticipant preferences for prolonged care (OR=12.64) and limited care (OR=2.63) were consistent with the care they received. Participants who elected comfort care were more likely to receive limited care. These fndings are consistent with those of Silveira, Kim & Langa (2010), who examined the HRS interviews con- ducted between 2000 and 2006, and thus further supports AD. More research is needed to understand the incongruence between appointed and actual decision makers at EOL. ADVANCE CARE PLANNING IN GERIATRIC PRACTICE: A MONTEFIORE MEDICAL CENTER QUALITY IMPROVEMENT STUDY D.F. Greenberg 1 , H. Blumen 1,2 , M. Ceide 1 , R. Marx 3 , 1. Montefore Medical Center, Bronx, New York, 2. Albert Einstein College of Medicine, Bronx, New York, 3. University of Pennsylvania, Philadelphia, Pennsylvania In 2016, The Division of Geriatrics of Montefore Medical Center received a grant through the New York Foundation for Elder Care to train primary care providers (PCP) in advance care planning (ACP) skills including: the explanation of prognosis and treatment options, clarifca- tion of the older adult’s wishes, and the utilization of the new Medicare reimbursement code for advance care plan- ning. A teaching module directed to the PCP was designed as a multidisciplinary consultation service using actual clini- cal cases presented by providers. Training in advanced care planning by the Geriatrics faculty was offered at the PCP sites. After initial implementation of this module, a quality improvement project conducted in the Division of Geriatrics during June 2016 through a chart review (n=101) examined the documentation of advance care planning discussions by the geriatrics faculty at its Geriatric Ambulatory Practice. Demographic data included age (M age=82), gender (75%=women), ethnicity (42%=Latino), preferred language (77%=English) and cognitive impairment (42%). The rate of documented advance care plans (32%) was analyzed. Results reinforced the need for training of geriatricians in ACP as well. Limitations include recent transition to a new electronic medical record, which complicated documentation; whereas 49% of patients reviewed had ACP on fle in the previous EMR, only 32% had such documentation in the new EMR. The teaching module was modifed based on the study’s fnd- ings to both improve the skills of attending physicians, fel- lows, and residents and to improve ACP conversations and documentation rates. EFFECTS OF AN ADVANCE CARE PLANNING EDUCATIONAL PROGRAM FOR CARE STAFF IN AN ACUTE HOSPITAL M. Hamayoshi 1 , S. Goto 1 , C. Matsuoka 1 , K. Miwa 3 , A. Kono 2 , M. Ikenaga 3 , 1. Bukkyo University, Kyoto, Japan, 2. Osaka City University, Osaka, Japan, 3. Yodogawa Christian Hospital, Osaka, Japan Purpose: Advance Care Planning (ACP) is a crucial end- of-Life Care practice. However, an ACP educational pro- gram for care staff in an acute care setting has not yet been established. The present study aimed to examine the effects of an ACP educational program in this clinical context. Method: The design was a single-arm study to evaluate staff attitudes pre-and post-program. A 90-minute inter- vention program was attended three times, along with self-directed study. The study outcomes included attitudes towards Advance Directrives (AD), the Death Attitude Inventory (DAI), and the Frommelt Attitude Toward Care of Dying scale (FATCOD-Form B-J). Result: A total of 57 care staff participated in the entire program (average age was 44.6 years old (SD 7.8); 11 men). The most common occupationai description was nurse (n=37). The scores on the attitudes towards AD scale increased from 9.96 (SD 1.0) to 10.3 (SD 0.9), which reached statistical signifcance (P=0.03). The score for ‘death relief’ in the DAI increased from 13.9 (SD 0.9) to 15.3 (SD 5.9), also P=0.03. The score for ‘positive attitude for end of life care’ in the FATCOD-Form B-J scale increased from 9.0 (SD 1.6) to 9.8 (SD 2.0), with P=0.01. Conclusion: These results suggest that the present ACP educational program was effective at improving staff atti- tudes relating to three key domains: attitudes towards AD, death, and the care of terminally ill patients. REDUCING EMERGENCY ROOM VISITS AND HOSPITAL DEATHS AT END-OF-LIFE FOR LONG- TERM CARE RESIDENTS S. Kaasalainen 1 , T. Sussman 2 , P. Durepos 1 , J. Ploeg 1 , L. Venturato 3 , L. McCleary 4 , P.V. Hunter 5 , 1. McMaster University, Hamilton, Ontario, Canada, 2. McGill University, Montreal, Quebec, Canada, 3. University of Calgary, Calgary, Alberta, Canada, 4. Brock University, St Catharines, Ontario, Canada, 5. University of Saskatchewan, Saskatoon, Saskatchewan, Canada Innovation in Aging, 2017, Vol. 1, No. S1 508 Downloaded from https://academic.oup.com/innovateage/article-abstract/1/suppl_1/508/3898697 by guest on 18 June 2020