Understanding Advance Care Planning

The Advance Care Planning is about patient-centred care. This is the process of planning future health and personal care. It usually involves choosing a person, preparing, and appointing an option decision maker and keeping his health preferences in writing. These can be widespread and may include the person's goals, costs and results from care or they may have specific treatment priorities.

Everyone should consider an Advance Care Planning regardless of their age or health. These conversations can happen between loved ones outside the health sector, but general practitioners (GPs) are in a great position to support the advance care plan. GPs have an important and reliable relationship with their patients. Not only GPs are informed about the current health of their patients, they can also promote the potential future health development and needs. And in many states and areas, Advance Care Directives need to be signed by a doctor.

Who needs an Advance Care Planning?

• Although the Advance Care Planning can be considered by anybody, it is especially important in the following scenarios:
• If the patient plans for advance care with a general practitioner team member
• Life is limited to disease or progressive disease (like COPD, heart failure, dementia or advanced cancer)
• If they are an Aboriginal and/or Torres Strait Islander Person, then their age is 75 years or more, or 55 years or more
• Is a resident of, or is about to enter, is an aged care facility
• The risk of losing capacity (such as dementia)
• There is a new important diagnosis (for example metastatic disease, transient ischemic attack)
• At an important point in their trajectory of the disease (for example, recruitment in a recent or repeated hospital)
• No one has (such as family, caregiver, friend) who can act as a decision maker
• Can predict the conflict decision about their future health care
• If the patient is failing or taking care of him

Advance Care Planning should not happen at once it is a process that can develop over time. Initial Advance Care Planning can only include negotiations. Later, a patient can appoint an option decision maker, and it can underline what is most important to them. When a patient develops a disease, they can then choose to make a more detailed treatment plan.

Conversation Opportunities

Listen to the potential conversation trigger. For example, if a patient says that they are battling treatment or they do not want to return to the hospital, then you can use these opportunities to start the topic. The questions you can ask include:

• I try to talk to all my patients that what they want if they become unhealthier have you ever thought about this?
• If you want to talk to me, are you unable to talk to me regarding important medical treatment decisions?
• What does it mean for you to 'live well'? What are your goals at this time?
• What do you think about where things are right now with your disease?
• Do your family (or carers or friends) know what you want?

Appointing Adjudicator

An alternative-decision maker is the voice of the patient when he cannot take his decisions anymore. A substitute decision maker should be a person who relies on the patient to express the priorities of the patient and who makes a difficult decision on the patient's ability.

In Australia, it is possible to appoint a substitute decision maker in all the states and regions, but their authority varies by jurisdiction. Advance Care Planning Australia website has links to useful resources to help patients and professionals with this process.

Develop an Advance Care Planning

Any person over 18 years of age with capacity can make advance care instructions. In Victoria, from March 12, 2018, people under the age of 18 may also give Advance Care Directives to be considered for capacity to care for medical care.

There are two forms of statement that a person can make: a price instruction and an instructional instruction. There are general statements about the values ​​of their priorities, values ​​and what matters to them. In an instructional instruction, a person can consent or refuse special therapy treatments. Specific details about the law differ throughout Australia. Advance Care Planning is a state-specific resource in Australia that can reach patients and professionals.

An Advance Care Directives Australia should ideally be discussed with a doctor, because it ensures that any decisions made will be made on the basis of the correct medical information. It also ensures that the healing physician is fully aware of the priorities of the patient and therefore is capable of providing better medical care which keeps these priorities in mind.

Deciding on the basis of good medical information will help future doctors to follow a directive with confidence.