Advance Care Planning (ACP). Tracy Reed RGN, BSc (Hons) DN MSc Queens Nurse Education Facilitator for End of Life Care The Harlow Integrated Team 2nd Floor The Latton Bush Centre Harlow Essex CM18 7BL Mobile no: 07770686994 Email: [email protected]
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Advance care Planning (ACP) is a process of discussion between an individual and their care provider irrespective of discipline.
The process of ACP is to make clear a person’s wishes and will usually take place in the context of an anticipated deterioration of the individual’s condition.
It is recommended that with the individual’s agreement this discussion is documented, regularly reviewed and communicated to key persons involved in their care.
National End of Life care programme. 2007 - Advanced care Planning: A guide for Health and Social Care staff.
“All people approaching the end of life need to have their needs assessed and their wishes and preferences discussed.”
Peoples choice and control should be central to the delivery of high-quality, end of life care.
Image: National End of Life Care Programme.
(National End of Life Care Programme, Advance Care Planning: a guide for health and social care staff. February 2007)
Three triggers that suggest that patients are nearing the end of life are:
1. The Surprise Question: ‘Would you be surprised if this patient were to die in the next year, few months, weeks, days’?
2. General indicators of decline - deterioration, increasing need or choice for no further active care.
3. Specific clinical indicators related to certain conditions.
1. Opening the conversation?
2. What options might be available to the person?
3. What sort of things might be identified?
4. What methods of recording or communicating
wishes are available?
The statement is not legally binding but should be used when
determining a person\'s best interests in the event they lose
capacity to make those decisions.
An ACP discussion might include:
ADRT enables a person aged 18 or over to refuse specific treatment in the future when they have lose capacity.
(Previously Known as Living wills or Advance Directives).
Must be valid and applicable to current circumstances.
Must state which treatment is being refused (they can cancel their decision).
Must be in writing
‘I didn’t want that’
Dame Cecily Saunders
Founder of the Modern Hospice Movement