Archives
Establishing a Sustainable Advance Care Planning Process in Residential Aged Care
Jeanine Blackford
Palliative Care Research Fellow, Austin Health, Clinical School of Nursing, La Trobe University, Melbourne VIC
Elizabeth Stickland
Program Manager, Respecting Patient Choices Program, Austin Health, Melbourne VIC
Bridget Morris
La Trobe University, Melbourne VIC
Abstract
A person’s right to self-determination in health care is now a fundamental principle of health care provision. As a consequence Advance Care Planning (ACP) is a critical issue in health care including palliative care as it is seen as a way of ensuring a person’s right to participate not only in future health care choices but in end of life decision making. To date there have been few reports of successful ACP programs.
In 2004 and 2005 a program of advance care planning, known as Respecting Patient Choices was introduced in 17 residential aged care facilities in metropolitan Melbourne, Australia. This program consisted of a system wide approach that included education for aged care staff; information for residents and families as well as changes to organisational processes to ensure that residents have opportunity for self-determination in their future health care.
This paper will report on the lessons learnt from this implementation and identify strategies which foster sustainability of ACP.
Keywords
Palliative care, advance directives, advance care planning, aged care
References
Australian Government Department of Health and Ageing (2004) Guidelines for a Palliative Care Approach in Residential Aged Care, Rural Health and Palliative Care Branch, Australian Government Department of Health and Ageing, Canberra.
Australian Institute of Health and Welfare (2007) Residential Aged Care in Australia 2005-2006: A Statistical Overview. Aged Care Statistics Series, AIHW, Canberra.
Department of Health and Ageing (1997) Standards for Aged Care Facilities. Australian Government, Canberra.
Hammes BJ and Rooney BL (1998) Death and end-of-life planning in one midwestern community. Archives of Internal Medicine 158: 383-390.
Lynn J, Nolan K, Kabcenell A, Weissman D, Milne C and Berwick D (2002) Reforming care for persons near the end of life: The promise of quality improvement. Annals of Internal Medicine 16: 117-122.
Marchand L, Fowler KJ and Kokanovic O (2006) Building successful coalitions for promoting advance care planning. American Journal of Hospice and Palliative Medicine 23:119-126.
Palliative Care Australia (2005) National Standards for Provision of Quality Palliative Care for all Australians 4th edn, Palliative Care Australia, Canberra.
Silvester W, Strickland EM, Adams MJ, O'Callaghan S and Kirsner S (2003) Respsecting Patient Choices Project: Final Report to the National Institute for Clinical Studies, Austin Health, Melbourne.
Singer PA, Robertson G and Roy DJ (1996) Advance care planning. Bioethics for Clinicians Series 6. CMAJ 155: 12.
Street AF and Ottman G (2006) State of the Science: Review of Advance Care Planning Models, La Trobe University, Victoria.
Tulsky JA (2005) Beyond advance directives: Importance of communication skills at the end of life. JAMA 294: 359-365.
World Health Organization Regional Office for Europe (2004) Europe: Better Palliative Care for Older People, World Health Organization, Copenhagen.
eContent Home