Advance Care Planning

ADVANCED PLANNING A guide for planning ahead

with the support of Anglican Care

We have developed this booklet to assist you and your family when it comes to planning for your future. It covers advanced care planning, including planning for loved ones with advanced dementia and explains the Palliative Care Approach.

At Anglican Care we understand it can be difficult to discuss future health decisions.

That is why all of our staff across all of our residential homes and community services have been trained in discussing Advance Care Planning.

Our staff are happy to meet with you and your family to help facilitate your discussions, explore your options and of course, write down some of the essential things you want people to know about your wishes when the time comes to making those important decisions.

Ask our friendly staff today and get started on your advance care plan. We know from experience, planning ahead provides peace of mind.

What is Advance Planning?

Advance care planning is the process of thinking and talking about what care and medical treatments you would want to receive before you might need them. It involves considering what options and choices are available to you.

This can be done by talking about your choices with your doctor, carers and family before there are changes in your health, or if you were to become unable to discuss these things.

Advance care planning involves creating a guide for your doctor, carers and family in case they need to make medical decisions on your behalf. By doing this, they will know what treatments would be acceptable to you and those which could be burdensome to you as an individual.

An Advanced Care Plan can record such things as your wishes, choices and preferences about future medical care and treatments, as well as document your values, beliefs, goals of medical treatment and, specify your end of life care choices and preferences.

There are many benefits to Advance Care Planning.

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It is a way of opening up discussion about what matters to you, what might happen in the future as you age and what you might like to happen at the end of life.

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It can be a way of reducing stressful decision making for those who might be asked to be your substitute decision maker.

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It raises the opportunity to identify your ‘person responsible’ who will

be your substitute decision maker. You may decide to legally appoint an ‘Enduring Guardian’ who has the legal rights to make health and lifestyle decisions on your behalf if you are not able to.

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Should you have a disease, discussions can be had about your disease trajectory and what you might expect in the future.

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As well as the opportunity to document both health care and medical treatment choices, to guide others in making substitute decisions on your behalf.

An Advanced Care Plan can be amended at any time, or as your condition changes. You may also wish to have an Advanced Care Directive document recorded which is ONLY used if you are unable to make medical decisions yourself.

Ask our friendly staff today for assistance with your Advance Care Planning, we are here to help.

What is Advance Planning for people with advanced dementia?

When a person has advanced dementia they are often unable to discuss their treatment choices themself so this is left to their ‘person responsible’ or ‘enduring guardian’. Often this person knows a lot about what the person would have wanted in regards to treatment and interventions so can then discuss this on behalf of their loved one.

Sometimes it is hard to know what a person would have wanted, at these times our staff will guide you through reflecting on what the person was like about other decisions in their life. What is important is that there is discussion and that the whole family start to feel comfortable with planning for the future as a person becomes frailer with advanced dementia.

Preparing for this time supports the family and the person with advanced dementia, in ensuring maximum comfort, at a time when some treatments may cause further distress and decisions are needed in a hurry.

An Advanced Care Plan can record such things as your loved one’s wishes, choices and preferences about medical care and treatments towards end of life. The plan can include statements about your loved one’s values, their beliefs and goals of medical treatment and care. As well as specifying the end-of-life care choices and preferences that you feel your loved one would want if they were able to speak for themselves.

Benefits of planning ahead for people with dementia •

It is important that your family agrees on care and treatment options on behalf of your loved one as they reach an advanced stage of their disease and end of life, rather than curative care.

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Planning ahead gives you an opportunity to discuss what is important to you and your family when losing a loved one, and what we can do to support you and your family at this time.

An Advanced Care Plan can be amended at any time, or as your loved one’s condition changes. The Plan can guide substitute decision making when a person cannot speak for themselves, and may include a previously documented Advance Care Directive.

For someone with advanced dementia, Advance Care discussions may include the following: •

Identification of the ‘person responsible’ or the legally appointed ‘Enduring Guardian’, so we know who will be your loved one’s substitute decision maker.

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Specific requests for care or treatment considerations that can enhance comfort and wellbeing for your loved one.

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Discussions about the disease progression of dementia and what you and your loved one might expect in the future.

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Discussions about medication and treatment that can enhance wellbeing and those that may no longer improve comfort.

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Documenting medical treatment orders to guide others in making substitute decisions on your loved one’s behalf if required.

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Discussing what options are available for health care and medical treatment within the Residential Care Home compared to hospital.

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As well as discussing instructions for the time of death and the time following so we know how we can support you in this journey.

Ask our friendly staff today for assistance with your Advance Care Planning for those with dementia, we are here to help.

“Underlying the philosophy of a palliative approach is the view that death, dying and bereavement are all an integral part of life.”

Standards for Providing Quality Palliative Care for All Australians (May 2005, pg11)

What is the palliative approach in aged care?

The Palliative Approach is focussed on supporting a person and their family in quality of life decisions once a chronic disease passes a ‘turning point’ in its trajectory. The approach allows people to make their own choices about treatments which may affect their quality of life, as opposed to accepting treatments to prolong their life at all costs. The Palliative Approach is not about stopping care or all treatment, instead the approach recognises that many older people require increased care services towards the end of life due to illnesses that are life limiting.

The approach ensures that a person and their loved ones have all the information they need to be involved in their treatment and care towards end of life. The Palliative Care Approach also supports Advanced Planning and Advanced Care Directives in recognising that people have the right to optimum wellness in the last years/months of life. It is about wellness, wellbeing and comfort at a time when curative treatments have little effect. It can also empower the person and their loved ones to determine how they want to live at this time.

Who receives Palliative Approach Care?

A palliative approach is appropriate for individuals with any life limiting illness and their families. Life limiting illnesses include cancer, chronic diseases such as heart, lung, kidney and liver disease, as well as stroke, dementia and Parkinson’s disease.

There are many benefits to the Palliative Care Approach including: •

The approach provides a focus on active, comfort focused care and a positive approach to reducing suffering and promoting an understanding of the dying process, loss and bereavement.

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It works towards supporting the older person and their family though the last months or weeks of life within their own private home or residential aged care home.

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Specialist Palliative Care Services can also be called upon to support the Palliative Approach where symptoms are causing discomfort and concern.

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The approach aims to maximise total wellbeing by meeting the holistic needs of the person and their carer, by way of physical, cultural, psychological, social and spiritual care.

The Palliative Approach enhances the care already provided to care recipients and their families in aged care. It incorporates an ongoing discussion with care providers about everyday life decisions. These decisions may be as simple as adjusting the daily routine to suit reduced capacity, or more detailed such as whether to have a skin lesion removed or where to be cared for during illness or death.

It is about having all the information about a disease and its likely progression so that a person or their person responsible can discuss and make informed choices about care and treatment towards end of life. Thorough assessment, open communication and informed choices can improve a person’s quality of life, and are all integral to the Palliative Approach in aged care.

Leaders in the Palliative Approach Anglican Care is leading the Palliative Approach, working with Hunter Aged Palliative Care Network (HAPCN) to develop resources and education for staff and families.

Find out more about HAPCN via their website www.hapcn.com.au

For further information please call:

Wanting our assistance with your future care plans?

Planning ahead can bring you peace of mind. Our friendly staff are available to discuss and facilitate discussions around your future care needs and explore your options.

Our staff are happy to meet with you and your family within your residential care home or your own home if you are a community consumer. Together we can discuss and record some of the important things you want people to know about your wishes, or the wishes of your loved one, when the time comes to making those important decisions.

We also have many staff trained in the Palliative Approach who can offer support and guidance, albeit within your residential care home or your own home if you are a community consumer.

Ask our friendly staff today for assistance or call our Customer Support Team on 1800 733 553. We are here to help.

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1800 733 553 ANGLICANCARE.COM.AU