by Mary Lynne Knighten
Are you one of the 70% of people who does not have an advance care plan (ACP)?
Advance care planning is the process of planning for future medical care. ACP is an ongoing course of action whereby patients, family members, and healthcare providers consider the patient’s goals, preferences, values, and beliefs, discuss how this informs their health and medical care now and in the future, come to mutual understanding of how everyone involved honors the patient’s wishes to meet their needs, and document future healthcare choices.
Planning in advance for decisions in the moment.
An advance care plan can be created at any age or stage of life. Whether a person faces an acute illness, a progressive, chronic condition, or terminal disease, advance care planning can help alleviate unnecessary suffering, improve quality of life, and provide insight into decision-making challenges a person experiences. ACP enables the person and his/her loved ones to “think through” what approach to take if—or when—the person’s health declines. It is a dynamic process and requires ongoing conversations as the patient’s medical condition or health status changes.
Ideally, ACP should be proactive, anticipatory, incorporated into routine medical care, and timed to maximize receptivity, engagement, and participation. ACP should include an examination of the patient’s knowledge, fears, wishes, and needs—not just medical issues, but life goals.
Ensuring that wishes are honored and needs are met.
The goal of ACP is to ensure that patients’ healthcare reflects their goals and values by engaging them (and family members, as the patient desires) in conversations to review their current condition, the future course of their disease, and their prognosis. Considering choices and what should and should not be done is the core of advance care planning.
Over time, loved ones may need to make difficult decisions in the best interest of the patient. A surrogate decision-maker should be chosen for the time when the patient is unable or lacks capacity to make healthcare decisions on his or her own. It is extremely important that patients express their wishes and goals for care and that the surrogate knows and understands their preferences. ACP provides a framework for informed decision-making for the surrogate, while reducing the burden they carry about whether the decisions they make follow the patient’s wishes.
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About the Author
Mary Lynne Knighten is an international speaker and published author on the topics of patient- and family-centered care, leadership, and whole-person health.