Session Four: Crucial care decisions, including attempting resuscitation and the role of the GP in ACP. ACP Learning Pack. Groupwork One. What particular aspects of care would you like to know about to help you care for someone as they would like, particularly at the end of their life?.
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When do you not attempt resuscitation on an older person who lives in a care home?
Questions to consider:-
6. There will be some people who lack the mental capacity to make those sort of decisions or enter into those discussions. How should staff proceed then?
10. Could you explain what is meant by the “surprise question”, which we find in the Gold Standards Framework? Does this question help in resuscitation decisions?
11. Do you think there are any differences in approaching the decision making process in a care home for older people, compared to another type of care setting?
12. Could you explore the differentiation in attempting resuscitation in (for instance an emergency situation where someone is choking) in comparison to when someone collapses suddenly in what may be a natural death.
5. If a person is thinking about making an advance decision to refuse treatment, particularly life sustaining treatment, would the GP be the person they should discuss this with?
7. Apart from resuscitation decisions, are there any other treatments which you think it would be a good idea to discuss with a person beforehand in advance of when they might possibly need that treatment?
10. In most cases, in a care home the GP will be the decision maker when it comes to treatment if the person is lacking the capacity to decide at that time. But what contribution can care home staff make to this decision making process?
12. So as far as advance care planning is concerned, is there anything you think the care home staff can do to help the GP be more involved in the process?