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April 22, 2020

Demi’s Palliative Care Blog

Advance Care Planning

With Demi Brooks

In last week’s blog, I talked about difficult conversations and the importance of having them with your loved ones.   

This week, I want to discuss how you can make a record of these conversations.

In doing so, this will enable your loved ones and health care professionals to be aware of your wishes should you become to unwell to communicate them yourself.  

Some of you may already have documents in place that state you or your loved ones wishes, or you may be thinking about this considering the current situation with the Covid-19 pandemic. 

What it really amounts to is nothing more complicated than having a think with your nearest and dearest about what would matter to you if you were to become really unwell.

Dr Rachel Clarke, 2020
Advanced Care Plans 

An Advance Care Plan (ACP) is a document that can be used to record yours or your loved ones wishes. It outlines the decisions made about any treatment or support you or your loved one would like if you were to become too unwell to communicate. It can be as detailed or as brief as you would like. 

An ACP incorporates a holistic, person-centered approach. It should encompass your health and wellbeing needs including your emotional, social, cultural, spiritual and religious needs.   

This is YOUR document and it belongs to YOU.

It should be all about your needs and wishes.   

Some questions to ask yourself when filling out an ACP are:  

  1. Where would you like to be treated? In hospital or at home? 
  2. Are there any treatments that you wouldn’t like to have, such as artificial ventilation, or other invasive treatments
  3. Would like family members to visit if you were to become unwell
  4. What you would like to happen to your pets  should you go into hospital? 
  5. Who and what are important to you? 

 

These are all important questions to ask yourself when making an Advanced Care Plan. Also remember to let your loved ones have a copy of your plan or let people know you have one so it can be followed. 

Planning Ahead 

Planning ahead is important whether you have a serious illness or not, as none of us can be sure that we will always be able to make our own decisions about our future care and treatment and communicate them. 

Knowing yours or your loved ones wishes can make it easy for family and professionals, to make the right decisions: the decisions you wanted, that you had thought about and discussed together and written down. 

It is important to note that an Advance Care Plan is not a legal document, unlike wills and lasting power of attorney.  This can be changed at any point, under your wishes and guidance. 

When I had the conversation with a loved one and helped him record his wishes, he was adamant he wanted to be cared for in his own home until the end.  

As his illness progressed, he became quite uncomfortable and unsteady, so after a discussing it with him he agreed to be admitted to the local hospice for pain management.  

After a few days there, he declared, “I don’t want to go home. I want to stay here. I feel safe.

Fortunately, we were able to change his Advance Care plan and record this 

It gave me comfort to know, his wishes were recorded and that we followed them just as he had wanted. 

Here are a list of Advanced Care Plan templates you can use:

 
Understand How You’re Feeling Is Normal 

As previously discussed, planning like this can unleash a range of emotions. This is completely normal; it’s the unknown territory for many of us and talking about it can be scary. 

Creating an Advanced Care Plan may be something that takes more than one attempt. Even I have thought about my own Advance Care Plan. I am 41 years old and currently well, so I’ve found it hard to plan ahead as there are some things I am not sure of at the moment. However, there are some things I know I would like to happen so I know I can record them and share with my family now.   

The important thing is that I have started to think about it. 

 —

In my blog next week, I will be talking about DNACPR and the new ReSPECT document. 

Stay Safe 

Demi Brooks is the Palliative Care Education Co-ordinator for Big C.

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