Assessing Advance Care Plan Discussions in Hospice Day Care

Rosalynde P. Johnstone*, Marlise Poolman, Kay Ryan, Penny Schofield and Bethany Watt

Assessing Advance Care Plan Discussions in Hospice Day Care.

Advance care planning aims to identify a personā€™s wishes and preferences in
anticipation of a potential deterioration in their condition in the future, with possible associated loss
of capacity to make decisions and/or ability to communicate wishes and preferences to others.

Department of Health ā€˜Together for Healthā€“Delivering End-of-Life Careā€™ sets out the Welsh
governmentā€™s strategy for end-of-life care whilst providing, a
comprehensive framework aimed at promoting high quality care for children
and adults approaching the end-of-life in all care
settings, stating that ā€˜individuals should be supported in planning
for the end-of-life with the help of professionalsā€™.

Being in the company of close friends and family ACP
can maximise patient autonomy and emerging evidence
suggests that this can lead to greater satisfaction with care.

Among healthcare professionals knowledge of ACP is patchy and many
patients are unaware that they can document their wishes and preferences in this way.

Sometimes the task of documenting wishes and preferences for future
care can be overwhelming. Utilising a pro-forma template
can assist in structuring and supporting discussions
around ACP whilst simultaneously organising and documenting
wishes and preferences, breaking the task down into manageable
ā€˜chunksā€™ or sections.

Within Betsi Cadwaladr University Health Board an ACP tool
which charts the process of advance care
planning has been developed, piloted and approved by BCUHB for use within North Wales.

The BCUHB ACP template is comprised of five sections and utilising this template as a structure,
palliative care providers are seeking to improve the opportunities for
ACP discussions and achievement of patientā€™s documented wishes and preferences at the end-of-life.

Palliat Med Hosp Care Open J. 2017; 3(2): 32-38. doi: 10.17140/PMHCOJ-3-125Ā