Advance care planning

Role of advance care planning 

Advance Care Planning (ACP) helps people to plan and prepare in advance for any decisions that need to be made. It encompasses communication issues, health system and medico legal considerations relating to care planning processes and documentation (such as the completion of Advance Directives) in advanced disease.

Allied health and advance care planning

In end-of-life care ACP is especially important as it assists health professionals to understand what choices and decisions have been made, how someone would like to be cared for, and the direction of treatment plans.

Allied health professionals may be involved with Advance Care Planning, perhaps as part of a conversation with a patient about their wishes. This could be in providing information and education to ensure informed choices are made, such as:

• Speech pathologists may discuss preferences for food or fluid intake - risk feeding versus safety (quality of life and comfort)
• Physiotherapists and occupational therapists may discuss goal setting, preferred place of care and preferred place of death
• Social workers may facilitate difficult conversations, help patients and families plan for end-of-life care through organising and facilitating family meetings to discuss patient wishes, enduring power of attorney, enduring power of guardianship, wills and funeral planning.

Allied health professionals may have the opportunity to participate in training on Advance Care Planning, although this will differ between disciplines and health services. There may also be an Allied Health Advance Care Planning representative in the service to approach for advice.

Advance Care Planning may have taken place, but this may not always be apparent. For example, patients do not always mention conversations with family and they are not always highlighted in the notes. If you are not a permanent member of the multidisciplinary team you need to be aware if any plans or documents exist. For example, this could be relevant for physiotherapists, who need to be aware of resuscitation wishes when taking patients away from the ward for treatment, or for patients in the community.