What is Advance Care Planning and Why is it Important in Palliative Care?
Advance care planning (ACP) is a process of discussing, deciding and documenting your preferences for your future health and personal care. It involves choosing a person who can speak for you if you are unable to communicate, and writing down your values, goals and wishes in an advance care directive (ACD).
ACP is especially important in palliative care, which is a type of care that focuses on improving the quality of life of people with life-limiting illnesses and their families. Palliative care aims to relieve pain and other symptoms, provide emotional and spiritual support, and help you live as well as possible until you die.
In palliative care, ACP can help you:
– Express your views and preferences about what matters most to you
– Have more control over your care and treatment options
– Reduce stress and anxiety for yourself and your loved ones
– Avoid unwanted or unnecessary interventions
– Ensure that your care is consistent with your values and wishes
How to Start Advance Care Planning in Palliative Care
ACP is a voluntary process that can be initiated by you, your family or your health care providers. It can be done at any time, but it is recommended to start early in the course of your illness, when you are still able to make informed decisions.
To start ACP in palliative care, you can:
– Talk to your doctor or palliative care team about your diagnosis, prognosis and treatment options
– Think about what matters most to you in terms of your quality of life, comfort level, personal dignity and spiritual beliefs
– Choose a person who knows you well and who can respect and represent your wishes if you are unable to speak for yourself. This person is called a substitute decision-maker (SDM) or a health care proxy. You should inform them of their role and discuss your preferences with them regularly.
– Write down your preferences for pain management, symptom relief, cultural support, personal care and place of death in an ACD. An ACD is a legal document that records your wishes for future health care. You can use a standard form or write it in your own words. You should sign it yourself or have someone sign it on your behalf if you are unable to do so. You should also give copies of it to your SDM, family members and health care providers.
How to Review Advance Care Planning in Palliative Care
ACP is not a one-time event but an ongoing conversation that may change over time as your condition progresses or as new information becomes available. You should review ACP regularly with yourself, your SDM, your family and your health care providers.