Report on Advance Care Planning
Discuss the possible benefits of Advance care planning for Anthony.
The process of advance care planning ensures to provide direction to professionals in the absence of the patient’s self-conscience. Advance care is planning which to enable the individuals to decide and make plans about their healthcare in future. Advance care planning can be utilised by individuals of at any stage of life. It reduces the level of stress and anxiety faced by the individual and his/her family. This consequently results in improvement in the health of the individual. During this course, the planning is done according to the preference and wishes of the concerned individual.
Advance care planning feature high number of benefits for the individual, and towards their family and caretakers. The care provided in case of advanced care planning is individualised such that the patient’s wishes are given preference as to what care and treatment they wish to receive along with the answers to when and how (Hickman et al, 2015). The associated professionals involve themselves in discussions with the patient regarding the goals and preferences, and the favoured place to undertake the process (Kite, 2010). The care offered is palliative in nature and the professionals involved focus on improving the quality of life (Brinkman-Stoppelenburg et al, 2014). Khan et al (2014) quoted that advanced care planning helps individuals to life to their fullest and in accordance with their preference. Many patients prefer to die at home. This process allows many patients to undergo their treatment at home which considerably reduces the cases of hospital admission (Houben et al, 2014). Such strategies allows health professionals to make arrangements such that people nearing the end of their life can spend more time with their family at home (Khan et al, 2014; Abel et al, 2013).
Advanced Care Planning gives the patients an opportunity to plan their care before they lose their ability to think or act (Ampe et al, 2015). It has been observed that families undergoing the advanced care planning experience less anxiety, stress or depression (Detering et al, 2010). Also, they are better prepared after their close one’s death. Families having pre-arranged legal and financial arrangements are found to be better prepared with a perception to continue their life in a better way. They can withstand the loss of their loved one with a will power to lead a sustainable life.
At what point might a conversation on advanced care planning be initiated with Anthony? There may be differing opinions on this within the literature, please describe these.
Advance care planning usually requires some time to commence. Effective and efficient advance care planning required highly skilled personals who can have an empathetic communication. It is necessary to understand when to initiate a conversation on advance care planning. Being well prepared is important to achieve the best possible outcome for the patient involved.
The conversation about advance care planning could be initiated at many situations amidst the person’s treatment which include:
When the patients show a keen interest in discussing his/her future treatment.
When the patient is hospitalized, the clinician might engage in initiating such a conversation.
When the patient starts facing an unstable state of illness.
It can be conversed on daily basis as a routine part of the treatment, especially for those who are nearing the end of life.
It is always advisable to initiate advance care planning with the patient at an early stage, with a mild conversation and subsequently progressing and inculcating the idea and requirement of advance care planning such that patient understands the scenario and provides complete support in the development of the plan (Van der Steen et al, 2014). The idea of making the patient understand the situation and its future planning ensures that the patient withstands the situation and the family members gain hope and confidence to sustain their life further. This is a slow and steady process, and the patient becomes prepared for the future and the family members as well provide complete cooperation. In this, the family also becomes better prepared, and consequently, they plan their future according to the future and survive and sustain accepting the truth.
Another scenario is when the patient has been diagnosed with a serious ailment, and his/her condition worsens daily such that they are unstable. Their condition is observed to weaken each day causing the patient to think about planning for the betterment of their family or caretakers. In such a condition, discussing about the advanced care planning makes the patient more susceptible to understand the density of the situation (Cruz-Carreras, Chaftari & Viets-Upchurch, 2017).
In both cases, the patients show interest in the process to secure their family’s future. Advanced care planning, as the name suggests, ensures a safe and sound planning for the patient’s family and to carry out the treatment according to the patient’s requirements and wishes.
Who should be involved in this discussion of advance care planning with Anthony?
The discussion involved in the advance care planning promotes and ensures specific patient-centred care. It causes an improvement in the communication of the patient and reduced burden towards decision-making is observed. In majority of the situations, advanced care planning faces lack of time due for proper preparedness (Ng & Chong, 2013). The best possible solution to counteract this time lack is by spending time with your family and caretakers as much as possible. Thus, in a discussion concerned with advance care planning, it is best to involve the patient’s family and caretakers to ensure the betterment of both patient and family or caretakers. This helps the Healthcare professionals to better understand the thoughts, emotions and expectations of the patient. Further the planning concerned with advance care can be prepared and performed in accordance with those preferences.
While discussing with the person it is necessary to keep in mind that the patient’s interest in every context is fulfilled and the person assessing the patient must be humble in his/her statements and not make any judgment based on the professional frontier of the patient.
Patients during the end of their life prefer to stay with their family if possible. They would want to spend as much time as possible with their family. Patients who are at the verge of their life are themselves depressed, and their association with the person’s they care would help them in living their final few days in the best possible way. Also, the patient’s family or relative or caretaker or friend with whom they have been maintaining a close association would be the best companion to lead their life in a situation in which they are unable to foresee their future. Those people have a better understanding about the patient, they would be able give additional inputs from their side regarding the patient’s wishes and expectations according to which the plan can be strategized and executed. In case of elderly people, they seek the support from their younger ones in order to lead their life and in majority of their decision-making process (Thompson, 2016). Similarly, when the patient requires assistance in terms decision-making their family members would be able to guide them in the best possible way as they would can understand the patient in a better way. They have spent so many years knowing the patient’s capabilities and they have been in constant support with the patient during the ups and downs of their life. A discussion involving the patient’s family member, caretaker, or friend would be an effi9cient boost for the patient and also, it would support the cause of prospective improvement in the experiences of patient and family members at the end of life (Myers et al., 2014).
What sort of information would be included in the advance care plan? Discuss any supporting documents (relevant in Victoria) that may be included in the Advance care plan.
Advance care plan evaluates the individual’s personal and professional life to ensure a feasible and quality treatment for the patient and his/her family healthcare and welfare. A person assessing the patient should not discriminate any point of view from the patient or the family side. All relevant and important situations, circumstances and issues must be given equal significance. The family member or caretaker should be consulted for any opinions put forward by the patient towards them. Advanced care plan should include the patient’s individual wishes and concern. It must focus on the important values, and their personal goals and expectations. The plan should be strategized based on the type of illness, its prognosis and effects. The patient must be given preference for the type of care he/she wishes to get administered with and the amount of supportive care they expect to achieve form the hospital and their family (Deliens, 2015).
Advance care planning can become an integral part of the care and communication associated with the individual. The patients deteriorating condition should be kept in mind while planning the process. The patient should be given at most attention and importance while designing the plan. As such standardised documentation is not followed in case of a general advance care plan in Victoria. Usually, it is best to document the patient’s wishes and expectations as it would be helpful for those who would be involved in the future care of the patient. It is as well useful in organising and managing a patient-friendly advance care planning scheme (Flo et al., 2016).
Firstly, an advance care planning conversation must identify the basic and underlying health decisions which are necessary for the person. Secondly, it should recognise and identify a person who would be able to make possible decisions in case of the patient’s absence. The selecting individual should be capable enough to consider every possible situation and make a feasible and relevant decision at any point of time. Thirdly, it is it is essential to hold the discussion in a proper suitable environment providing ample time for the discussion to commence and end.
The cycle of advance care planning consists of three phases.
Develop – It consists of conversing with the patient about advance care planning and knowing about their decisions.
Review – It is done when a patient refines his/her goals or expectations about the care and treatment amidst the course of their illness.
Activate – An advance care plan is activated when the patient is not in a state to communicate or get involved in the process of decision making directly.
This cycle of events is generally followed in case of advance care planning for almost all diseases. Patients suffering from cardiovascular diseases need to have an updated advance care plan for their treatment. This ensures that they get adequate amount of care and attention in the perspective of gaining the best possible treatment for their family and themselves (Das, 2016). Each step associated with the advance care plan should be given high significance and the patient should be treated in an effective and efficient manner.
When would the advance care plan be reviewed?
An advance care plan primarily consists of three stages when planning and documenting the decisions: Develop, Review and Activate. Communication is the major source of interaction in the case of the advanced care planning. The first step in advance care planning involves the documentation of the basic information obtained from the patient. The concerned patient is involved with another individual who would initiate the conversation and brief about the basics of advance care planning. The patient is then given complete freedom to analyse and reflect his/her own perceptions on this context. The patient is given complete knowledge, guidance and information about the planning. Further the patient’s ideas, goals and expectations are recorded and documented for further study. A properly strategized plan is designed as per the requirement of the patient (Doran & Austin-Crowe, 2015).
Secondly, the process of review plays an important role in the advance care planning. This plan can be reviewed at any stage. It is necessary to review the plan because patients refine their goals for care and treatment through the course of their illness. Advance care plan needs to be up-to-date so that it is made easier for the clinician to assess and analyse the patient (Vinen, 2002).
Whenever a patient addresses any concern in the treatment or care offered by the clinician, it is understood that the advance care plan needs to be reviewed. In such cases, before amending the advance care plan, it is more feasible to discuss the existing plan of action with the patient. The patient’s idea, and expression can be made note of and documented. Actions which differ can be modified and recorded accordingly for the better preparedness, care and treatment of the patient.
Review of the advanced care plan is primarily done in order to ensure that the patients are given nurtured treatment on the basis of their expectations. Most importantly, the patient’s satisfaction and wish is considered as the primary goal of foundation. The clinicians plan and place the brick of treatment to build a strategized structure to address the needs and requirements of the patient. This indeed gives good memories for the patient and family towards the end of their life. The patients feel satisfied as they undergo their treatment in accordance with their stand standard and with their beloved family.
When would the advance care plan be activated?
When a person is unable to communicate or act independently or get involved in the process of decision making directly, the process of advance care plan gets activated. It is the patients lack capability to convey or inability to communicate initiates the advance care planning scheme. The plan is activated with respect to the person who is nominated as a substitute for the patient’s decision-making process and the family members (Schellinger, 2012). The concerned person is responsible for taking any further decision with respect to the patient after the activation of the advance care plan. Clinicians involved in the person’s care are responsible for activating the advance care plan in consultation with the nominated substitute decision maker and family members (Cartwright, Montgomery, Rhee, Zwar & Banbury, 2014).
Once it is completely ensured that the patient is unable to make his/her own decision, the clinicians make sure that the patient is completely under their supervision with the decision-making power to be handled by the concerned nominee. While arranging with respect to the patients’ health and welfare the clinicians make sure that they abide by the set rules as listed in their advance care plan and also, it follows the goals of the patient. They make sure that the patient’s complete set of expectations are fulfilled towards his/her treatment and towards their family. The patient is treated with very high efficiency and it is ensured by the clinicians that the patient gets to lead happy and memorable moments throughout the treatment procedure, spending the most time with their family.
The nominated person is responsible for making decisions related to what further treatment is required for the person. It is the nominee’s decision check for further advancement in the treatment. He/she must be considerate enough to understand the stage of critical illness the patient has reached and perform necessary actions accordingly. He/she must ensure that proper planning and execution is done on the part of advance care planning. The family members and the patient should be given proper care and their psychological needs should be addressed to mend their minds towards positivity.
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