Advance care planning in Canada

2018 ◽  
Author(s):  
Doris Barwich ◽  
John You ◽  
Jessica Simon ◽  
Louise Hanvey ◽  
Cari Hoffman
Keyword(s):  
Advance Care Planning ◽  
Stakeholder Participation ◽  
Care Planning ◽  
Governmental Organizations ◽  
Engagement Strategies ◽  
National Initiatives ◽  
Non Governmental Organizations ◽  
Advance Care ◽  
End Of Life Communication ◽  
National Framework

This chapter describes how advance care planning (ACP) is being implemented in Canada. It highlights the use of an organizing National Framework for Advance Care Planning and a recent conceptual framework of end-of-life communication and decision making. A feature of the Canadian landscape are networks of collaboration and partnerships including research and non-governmental organizations, and examples of regional and national initiatives are presented in the boxes. A summary is provided of barriers, facilitators, the cultural milieu, and future opportunities for ACP in Canada. Implementation of ACP in Canada has followed a multi-faceted approach, with significant national leadership, key stakeholder participation and consumer engagement strategies, with important outcomes demonstrated.

scholarly journals Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria

2015 ◽  
Vol 39 (5) ◽  
pp. 552 ◽  
Author(s):  
Tim Luckett ◽  
Priyanka Bhattarai ◽  
Jane Phillips ◽  
Meera Agar ◽  
David Currow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Treatment ◽  
Advance Care Planning ◽  
Consumer Choice ◽  
Population Level ◽  
Care Planning ◽  
Advance Care ◽  
Advance Care Directive ◽  
Online Availability ◽  
National Framework

Objectives A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. Methods A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Framework for Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Results Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment – the Dying with Dignity Victoria Advance Healthcare Directive. Conclusions More research is needed to understand how online resources can optimally elicit and record consumers’ individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement. What is known about the topic? Online availability of ACD templates provides consumers with an opportunity for advance care planning outside of formal healthcare settings. While online availability has advantages, there is a risk that templates may be biased either for or against medical treatment and may not elicit directives that are appropriately informed by reflection on personal values and discussion with family and health professionals. What does this paper add? This is the first attempt at monitoring the quality and bias of online ACD templates designed for use in Australia. What are the implications for practitioners? The results of this review provide a description and quality index to assist consumers and clinicians in deciding which online ACD template to use or recommend.

End-of-life communication in Korean older adults: With focus on advance care planning and advance directives

2015 ◽  
Vol 16 (4) ◽  
pp. 407-415 ◽  
Author(s):  
Dong Wook Shin ◽  
Ji Eun Lee ◽  
BeLong Cho ◽  
Sang Ho Yoo ◽  
SangYun Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Advance Directives ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
End Of Life Communication

scholarly journals Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness

2018 ◽  
Vol 32 (8) ◽  
pp. 1305-1321 ◽  
Author(s):  
M Zwakman ◽  
LJ Jabbarian ◽  
JJM van Delden ◽  
A van der Heide ◽  
IJ Korfage ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Care Planning ◽  
Iterative Search ◽  
Future Care ◽  
Life Threatening ◽  
Research Findings ◽  
Advance Care ◽  
The Individual ◽  
End Of Life Communication

Background: Advance care planning is seen as an important strategy to improve end-of-life communication and the quality of life of patients and their relatives. However, the frequency of advance care planning conversations in practice remains low. In-depth understanding of patients’ experiences with advance care planning might provide clues to optimise its value to patients and improve implementation. Aim: To synthesise and describe the research findings on the experiences with advance care planning of patients with a life-threatening or life-limiting illness. Design: A systematic literature review, using an iterative search strategy. A thematic synthesis was conducted and was supported by NVivo 11. Data sources: The search was performed in MEDLINE, Embase, PsycINFO and CINAHL on 7 November 2016. Results: Of the 3555 articles found, 20 were included. We identified three themes in patients’ experiences with advance care planning. ‘Ambivalence’ refers to patients simultaneously experiencing benefits from advance care planning as well as unpleasant feelings. ‘Readiness’ for advance care planning is a necessary prerequisite for taking up its benefits but can also be promoted by the process of advance care planning itself. ‘Openness’ refers to patients’ need to feel comfortable in being open about their preferences for future care towards relevant others. Conclusion: Although participation in advance care planning can be accompanied by unpleasant feelings, many patients reported benefits of advance care planning as well. This suggests a need for advance care planning to be personalised in a form which is both feasible and relevant at moments suitable for the individual patient.

scholarly journals The importance of living well now and relationships: A qualitative study of the barriers and enablers to engaging frail elders with advance care planning

2021 ◽  
pp. 026921632110132
Author(s):  
Sarah Combes ◽  
Karen Gillett ◽  
Christine Norton ◽  
Caroline Jane Nicholson
Keyword(s):  
Decision Making ◽  
Advance Care Planning ◽  
Family Relationships ◽  
Care Planning ◽  
Clinical Frailty Scale ◽  
Frail Elders ◽  
Barriers And Enablers ◽  
Living Well ◽  
Engagement Strategies ◽  
Advance Care

Background: The population of frail elders is growing, and due to their vulnerability to sudden deterioration, advance care planning is particularly important. However, advance care planning is uncommon for multiple reasons, some of which are linked to the perceptions of frail elders and their families. Aim: To explore the barriers and enablers to advance care planning engagement with frail elders. Design: Qualitative in-depth interviews with thematic analysis. Setting/participants: Purposive sample of 10 frail elders and 8 nominated family members using a community-based older persons’ service run by a large urban UK hospice. Frail elders had capacity, were ⩾65 (median 85, range 71–95), scored 6 or 7 (median 6.5) on the Clinical Frailty Scale, and 70% were female. Results: Key barriers were: Advance care planning is unclear, in terms of meaning and the language used; Lack of relevance, with frail elders preferring to focus on living well now; and the Importance of family, relationships and home, and the influence of relationship on end of life decision-making. Engagement strategies included preparing the frail elder for advance care planning conversations and using a gentle, honest, individualised approach. Conclusions: Essential enablers for frail elders are understanding what advance care planning is and why it may be relevant to them. For professionals, enablers include recognising the importance of living well now and relational decision-making. To further support advance care planning, recommendations include early engagement and re-conceptualising advance care planning as an ongoing process which encompasses current and future care. Further research is needed in different cultures and care contexts.

Advance care planning in Australia

2018 ◽  
Author(s):  
Karen Detering ◽  
Josephine Clayton
Keyword(s):  
Advance Care Planning ◽  
Aged Care ◽  
Care Planning ◽  
Care Services ◽  
Early Implementation ◽  
Care Workers ◽  
Care Systems ◽  
Advance Care Directives ◽  
Advance Care ◽  
National Framework

For some time, there have been significant efforts in Australia aimed at increasing the uptake of advance care planning (ACP) by the population, health care and aged care workers, and health and care systems. This has included the development of a national framework for advance care directives, a national palliative care framework, and some funding to support implementation projects and evaluation of these. Programmes have occurred in hospitals, primary care, aged care services, and in the community. There has also been a focus on education of staff across these settings. Despite this, prevalence of ACP and advance care directives remains low. There remains lack of national legislation regarding advance care directives, and poor understanding of ACP amongst the population and professionals. Much of the early implementation has focused on staff training in facilitating ACP discussion. More recently newer models of ACP implementation are occurring.

Demenz aus palliativmedizinischer Perspektive: warum ein krankheitsspezifisches Advance Care Planning wichtig ist

2018 ◽  
Vol 75 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Ralf J. Jox ◽  
Francesca Bosisio ◽  
Eve Rubli Truchard
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
Menschen Mit Demenz

Zusammenfassung. Die Palliative Care muss sich im Zuge des demographischen Wandels vieler Gesellschaften rund um den Globus tiefgreifend wandeln. Sie muss mehr und mehr mit der Geriatrie zusammenarbeiten und geriatrische Expertise integrieren. Eine der zentralen Herausforderungen Geriatrischer Palliative Care ist die ethisch angemessene Therapieentscheidung für Menschen, die nicht mehr urteilsfähig sind. Nachdem der bisherige Ansatz herkömmlicher Patientenverfügungen erwiesenermassen enttäuscht hat, wird aktuell, gerade auch in deutschsprachigen Ländern, das systemische Konzept des Advance Care Planning (ACP) verfolgt. In diesem Artikel wird zunächst ACP mit seinen Zielen, Elementen und Effekten vorgestellt. Sodann wird gezeigt, weshalb es für Menschen mit Demenz eines adaptierten ACP-Programms bedarf und was ein solches demenzspezifisches ACP beinhalten muss.

Die Patientenverfügung «Plus» – das Konzept des Advance Care Planning (ACP)

Praxis ◽  
2017 ◽  
Vol 106 (25) ◽  
pp. 1369-1375 ◽  
Author(s):  
Barbara Loupatatzis ◽  
Tanja Krones
Keyword(s):  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

Zusammenfassung. Advance Care Planning ist ein begleiteter, strukturierter Prozess, der es Patienten und ihren Angehörigen ermöglicht, sich mit ihren Einstellungen zu Leben und Sterben sowie möglichen Behandlungen für den Fall einer Urteilsunfähigkeit mit Hilfe eines ausgebildeten Beraters auseinander zu setzen. Das Konzept kombiniert die individuelle Beratung des Patienten mit einem regionalen, systemischen Ansatz, der sicherstellt, dass alle Beteiligten die verwendeten Dokumente kennen und auch in einer Notfallsituation korrekt anwenden können. Ziel ist es, die Behandlung von urteilsunfähigen Patienten besser im Sinne ihrer Wünsche und Bedürfnisse zu koordinieren und dadurch die Patientenautonomie zu stärken.

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