Unit 2: Benefits of advance care planning
Learning objectives
By the end of unit 2, you will:
- Be aware of the benefits of advance care planning for people receiving care, those important to them, and community and district nurses.
- Understand the challenges of advance care planning and potential solutions.
It is important to have open and honest conversations about advance care planning, this will help normalise the process and offer reassurance and support to all. Being prepared for these discussions, and aware of the benefits and challenges will support understanding and confidence in the process.
Considering the benefits and addressing potential challenges early will help support people to progress from thinking to discussing and recording their thoughts through shared decision making.
Reflective Activity
- Have a think about the benefits of advance care planning in your practice. Make note of the main benefits for individuals receiving care and those important to them.
- What challenges have you faced, or do you think might arise during an advance care planning discussion? How would you overcome these challenges?
What are the benefits of advance care planning for those receiving care?
Individual’s preferences are known
Ensures an individual’s preferences are known to those important to them and are recorded for health care professionals involved in their care. This provides comfort and increases the likelihood that their wishes are known and carried out.
Gives the individual receiving care a voice
Gives the individual receiving care a voice particularly if they may lose capacity to advocate for themselves in future. This promotes shared decision making and a sense of control over future care. The individual may also feel comforted that those important to them will not have to make these difficult decisions in future.
Opportunity for realistic discussions
Provides an opportunity for a detailed discussion on the risks and benefits of different treatment options. This promotes realistic conversations about future care and treatments that may or may not work in specific circumstances. This will reduce the risk of any unwanted or unnecessary treatments or hospitalisations where this may not be in an individual’s best interests.
What are the benefits of advance care planning for those important to the individual?
Awareness of individual’s wishes & preferences
Ensures those important to the individual are aware of their wishes and preferences for future care. This will provide confidence and offer reassurance if involved in care decisions on behalf of the individual in the future.
Proactive in the process
Empowers those important to the individual to be proactive in the process and aware of decisions made around future care. This will help people understand care decisions and provide those important to the individual with realistic expectations.
Reduce the risk of family disagreements
Can reduce the risk of family disagreements and misunderstanding if those important to the individual are aware of their wishes.
What are the benefits of advance care planning for Community and District Nurses.
Delivery of personalised care
Early advance care planning supports the delivery of personalised care and implementation of the individual’s wishes and preferences for the future. This provides reassurance for staff knowing that the individual’s wishes will be followed should their health deteriorate.
Less stressful, more positive work environment
Creates a less stressful, more positive work environment as nurses and other health care professionals can be confident, they are making care decisions with the individual’s wishes and preferences in mind.
Improves communication
Improves communication between everyone involved in the discussion and reduces the potential for misunderstandings, conflict, or disagreements regarding the individual’s future care.
Challenges faced during advance care planning discussions
Challenge
The individual may be reluctant to discuss advance care planning
If this happens, remember that advance care planning is a voluntary process. It is important to note this on their record [as discussed within unit 4] and look out for cues to sensitively approach the topic again in the future. A person may change their mind as their condition progresses or circumstances change and wish to develop an advance care plan in the future.
Challenge
Disagreement between family members about the individuals’ decisions.
If this happens, remember that the process should centre around the wishes and preferences of the individual. Use active listening skills and a sensitive, empathetic approach to let everyone voice their concerns and opinions. It is important to work together and help everyone understand the wishes and preferences of the individual.
Challenge
Expectations may be different from reality.
A person’s wishes and preferences may not always be achievable. If this happens, it is important to always be open and honest and have realistic discussions about future care, what treatment options are available, including discussion on risks and benefits.
Reflective Activity
- Take a few minutes to reflect and make a few notes on the information covered in unit 2. What do you think are the key points? How could you use this information in practice?
- Based on your experience, what do patients and families value most about advance care planning?
In the video below, Andrea Partridge discusses how ACP supports individuals, families, and caregivers.