Advance care planning is typically initiated during the last six months of a patient's life. However, due to the progressive decline in the decision-making process in individuals with dementia, their involvement in advance care planning is limited to the early stages of the disease. Currently, there is no consensus on the optimal timing for initiating advance care planning for people with dementia, and a comprehensive review of the literature addressing this matter is lacking. To explore the experiences and perspectives of people with dementia, their family caregivers, and health care professionals with regard to the optimal timing for initiating advance care planning. A meta-synthesis was conducted. The following eight electronic databases were searched: PubMed, Embase, Web of Science, Cochrane Library, CINAHL and CNKI, WanFang and Vip. This review uses thematic synthesis to systematically synthesize qualitative evidence and report findings according to The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and the Joanna Briggs Institute Manual for Evidence Synthesis. Study selection and data extraction were conducted independently by two researchers, and quality was evaluated using the Joanna Briggs Institute's Qualitative Research Standard Assessment tool. Twenty-one studies were selected for this review. This review involved an overarching theme: The utilization of pivotal elements to transition from delayed initiation to comprehensive implementation. Three themes emerge, including the prerequisites for initiating advance care planning, not ready to start advance care planning and struggling along narrow roads. For health care professionals, the selection of an opportune moment to initiate advance care planning for people with dementia is not only a challenge but also a crucial prerequisite for the successful implementation of advance care planning. Health care professionals' experience, attitude toward advance care planning, trust relationship with patients, cultural differences among people with dementia and their caregivers, and economic disparities all influence health care professionals' judgment of the timing for initiating advance care planning. Determining the optimal timing for initiating advance care planning is a complex process that requires a comprehensive consideration of the realities faced by health care professionals, people with dementia and their caregivers. Therefore, it is imperative to provide relevant training to health care professionals to ensure the successful implementation of advance care planning.

中文翻译：

---

关于轻度至中度痴呆患者启动预先护理计划的最佳时机的经验和观点：荟萃分析

预先护理计划通常是在患者生命的最后六个月开始的。然而，由于痴呆症患者的决策过程逐渐下降，他们对预先护理计划的参与仅限于疾病的早期阶段。目前，对于为痴呆症患者启动预先护理计划的最佳时机尚未达成共识，并且缺乏对解决这一问题的文献的全面回顾。探讨痴呆症患者、其家庭护理人员和医疗保健专业人员对于启动预先护理计划的最佳时机的经验和观点。进行了荟萃合成。检索了以下8个电子数据库：PubMed、Embase、Web of Science、Cochrane Library、CINAHL和CNKI、万方和Vip。本综述使用主题综合来系统地综合定性证据，并根据增强定性研究综合报告的透明度 (ENTREQ) 和乔安娜·布里格斯研究所证据综合手册报告研究结果。研究选择和数据提取由两名研究人员独立进行，并使用乔安娜·布里格斯研究所的定性研究标准评估工具评估质量。本次综述选择了二十一项研究。这次审查涉及一个总体主题：利用关键要素从延迟启动过渡到全面实施。出现了三个主题，包括启动预先护理计划的先决条件、尚未准备好启动预先护理计划以及在狭窄的道路上挣扎。对于医疗保健专业人员来说，选择合适的时机为痴呆症患者启动预先护理计划不仅是一项挑战，也是成功实施预先护理计划的重要前提。医疗保健专业人员的经验、对预先护理计划的态度、与患者的信任关系、痴呆症患者及其护理人员之间的文化差异以及经济差异都会影响医疗保健专业人员对启动预先护理计划时机的判断。确定启动预先护理计划的最佳时机是一个复杂的过程，需要全面考虑医疗保健专业人员、痴呆症患者及其护理人员所面临的现实。因此，必须对医疗保健专业人员进行相关培训，以确保预先护理计划的成功实施。