Helping people share what matters most: Planning for future health care
An article written by Dr Catherine Joyce and Lesley Habel
Advance care planning involves exploring and documenting a person’s health care wishes and preferences, so if there comes a time when the person is unable to communicate for themselves, those wishes and preferences can guide care decisions. It is a voluntary process and an ongoing process that may involve multiple conversations over time. It may also involve preparing, reviewing, or updating formal documents. National Advance Care Planning Week, 18 – 24 March, reminds all of us to share what matters most.
Advance care planning is integral to high quality, person-centred care. The proposed new Aged Care Quality Standards set out clear expectations for aged care providers in relation to advance care planning, both for care in general (Action 3.1.6) and for care at the end of life (Action 5.7.2). [1]
Starting the conversation about advance care planning is an important first step in ensuring a person's preferences for future care are known and respected. Sometimes it can be hard to know what to say. Advance Care Planning Australia's conversation starters offer some suggestions for how to open a conversation about what matters most to a person: what they value, what is important to them and what they are worried about. You can also ask:
- Have you thought about who you would want to make decisions about your care if you were not able to communicate for yourself?
- What are the important things you want that person to know, to help make it easier for them to make decisions on your behalf?
Conversations about future care should ideally involve a person’s loved ones. This may include someone they have formally appointed as their substitute decision-maker, their biological or chosen family or other important people in their life. It’s common for residents in aged care homes to have some impairments in decision-making. Even if this is the case, you should make efforts to ensure that residents are supported to express, to the best of their ability, what is important to them.
As a person’s health declines and they approach their end of life, it can be a difficult and emotional time for loved ones. Sometimes it’s hard for them to separate out the person's wishes and preferences from their own. You can help by focusing conversations on the person’s own choices, while also acknowledging loved ones feelings and circumstances. For example:
- I know this is a hard time for you. I want to help you honour what dad/aunty/grandmother would have wanted.
- Did you talk with them about what they wanted at this stage?
- What do you know about what’s important to them, or what worries them?
- Let’s look at what they have written down about what they wanted, so we can make sure their choices are respected.
Advance care planning can improve satisfaction with care and reduce distress and conflict for loved ones involved in end-of-life care decisions. [2,3] Visit Advance Care Planning Australia for more resources to help you support the people in your care to share what’s important to them.
National Advance Care Planning Week encourages all Australians to plan their future health care and start the conversation today. For more information visit acpweek.org.au
For free advice or to request a printed starter pack, call the National Advance Care Planning Support ServiceTM on 1300 208 582 from 9am - 5pm (AEST/AEDT) Monday to Friday.
Advance Care Planning AustraliaTM is funded by the Australian Government Department of Health and Aged Care and administered by Brisbane South Palliative Care Collaborative, Metro South Health.
Authors
Catherine Joyce
Manager
Brisbane South Palliative Care Collaborative
Lesley Habel
National Manager
Advance Care Planning Australia
Reference
- Australian Government Department of Health and Aged Care. The strengthened Aged Care Quality Standards – Final draft (November 2023) [Internet]. Canberra, ACT: DoHAC; 2023 [cited 2024 Feb 28]. Available from: https://www.health.gov.au/resources/publications/the-strengthened-aged-care-quality-standards-final-draft?language=en
- McMahan RD, Tellez I, Sudore RL. Deconstructing the complexities of advance care planning outcomes: What do we know and where do we go? A scoping review. J Am Geriatr Soc. 2021 Jan;69(1):234-244.
- Brazil K, Carter G, Cardwell C, Clarke M, Hudson P, Froggatt K, McLaughlin D, Passmore P, Kernohan WG. Effectiveness of advance care planning with family carers in dementia nursing homes: A paired cluster randomized controlled trial. Palliat Med. 2018 Mar;32(3):603-612.