Advanced Care Planning: Everything you need to know

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If you are a care professional, there may be times when you need to consider suggesting Advanced Care Planning for your care recipients, especially if they or their families are unaware of what it means.  

Advanced Care Planning is actually extremely beneficial and can provide comfort for care recipients who may be facing failing health.  It also helps their loved ones feel peace of mind that their family member or friend will be well looked after in the way they wish to be – when they need it most. Of course, it’s also worth bearing in mind Advanced Care Planning is not just for elderly care recipients, it may also be necessary to think about it for others who may experience a medical dilemma. 

In this piece, we’ll explore Advanced Care Planning a little more, so you have the information you need to offer advice on the process.

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What is Advanced Care Planning (acp)?

Advanced Care Planning, also known as Anticipatory Care Planning in Scotland, is the practice of asking the person being cared for how they would prefer to be treated both now and in the future. It is a voluntary process, and is often used for domiciliary, palliative and complex care. Advanced Care Planning often takes the form of a set of questions that help inform and guide the person being treated towards sharing information that allows their care professionals to provide treatment in line with their wishes. These questions could include...

• Do you prefer to be treated at home or in residential care?
• Do you have any strong religious or spiritual beliefs that should be taken into account?
• Who do you prefer to spend time with during the day or on special occasions?
• Who should your care professional or medical team speak to if you are unable to make decisions?
• Would you like to be resuscitated should you suffer cardiac arrest or fall into a coma?
• What would you like to happen to your pets once you pass on?
• What would you like to happen to your body once you pass on?

Advanced Care Plans are not legally binding - but they provide great peace-of-mind for family members, care professionals and anyone involved with the care of the individual concerned.

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Who is Advanced Care Planning for?

Advanced Care Planning is usually put into place when someone has a terminal illness, an illness that’s viewed as serious or they may be at the end of their life.

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Why is Advanced Care Planning important?

Sometimes, it’s not always a doctor, nurse or care professional who recommends an Advanced Care Plan as a course of action – it might be the care recipient themselves who requests it, or one of their loved ones.  That’s because it’s a voluntary process. There’s no necessity for care recipients to think about what they might want in the future with regards to their care, should failing health put them in a position where they can’t make their own decisions but nevertheless, it is important. That’s because everyone has a right to receive the type of care that they want.  It’s also very comforting to understand what’s involved in future care, and to have specific requests in place in advance.  This is another reason why it’s important to document a care recipient’s wishes – especially if they are reaching end-of-life or they face an extremely challenging medical situation.

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How do you plan for Care in Advance?

There isn’t a specific method used to design Advanced Care Planning for a care recipient – the process is fluid and flexible.  It can be amended and changed as often as the care recipient wishes (and their family too).  As a care professional, you too might want to be involved with suggestions for the type of care that might be required.  There are some ideas below on what should be considered:

• If you think that your care recipient might require Advanced Care Planning, gently raise it with them if they are capable of making their own decisions.  Should they be happy for you to do so, you might want to also talk about it with one of their loved ones too.  Of course, if your care recipient cannot make their own decisions, then do talk to one of their loved ones about what can be done going forwards.
• Within Advanced Care Planning, there are lots of different things to consider.  For example, for those who are reaching end-of-life care, they may benefit from hospice care.  Of course, some care recipients and their loved ones prefer for this type of care to be carried out at home, as often this is a great comfort to the care recipient (and their family).  There are other wishes that your care recipient might want to talk about – for example, they may wish to donate their organs after they pass away or have other special requests.  It’s always wise to write these wishes down in advance and give them to loved ones, as well as keeping a copy yourself, as the homecare provider. This is part of Advanced Care Planning.
• There’s also what’s known as a Living Will, or Advance Decision to Refuse Treatment.  Your care recipient might want to put this in place should they become unable to make their own decisions going forwards and not want further treatment.
• An Advanced Statement is another aspect of Advanced Care Planning, and it allows your care recipient to keep a note of anything else that’s important to them with regard to their end-of-life care.
• One aspect that is very important is an LPA – or Lasting Power of Attorney for Health and Welfare.  This gives your care recipient the option of permitting a loved one to make health care decisions on their behalf, should they become unable to make their own decisions.
• Another aspect of Advanced Care Planning is deciding whether or not to use emergency intervention to keep a care recipient alive.  There are various methods that doctors can use to try and prolong life – such as resuscitation, using a ventilator or feeding through a tube, for example.  Some care recipients do not want such interventions, by putting wishes in place in advance, everyone is aware of future care planning.
• At end-of-life, there’s also something that’s often referred to as Comfort Care. This is the type of care that keeps someone as comfortable as possible, minimising suffering as much as possible.  Often, it involves, managing shortness of breath, reducing the need for intrusive medical testing and even offering counselling.

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Managing Advanced Care Planning

While it is not up to you as a care business to organise your care recipients’ Advanced Care Planning, if you feel it might be beneficial, do raise it gently.  You might suggest that the person in question (or their loved ones) also talk to their doctor or medical practitioner and consider the type of treatment they do or don’t want in an emergency.  It’s important that anyone putting together an Advanced Care Plan think about their choices thoroughly, although as mentioned, plans can be changed whenever required.  

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