Advanced Care Planning

Question 1

Definition of advanced care planning

Answer 1

Predicting what problems a patient may experience in next few months in terms of their illness
Create set of specific goals with patient to prevent crisis

Question 2

Why should the patient be involved in advanced care planning

Answer 2

Improves outcomes
Improves compliance
Goals more realistic and acceptable
HCPs more aware of patients baseline

Question 3

Who is advanced care planning for

Answer 3

Comorbidities
Frail
Cognitive impairment
Palliative

Question 4

What is SPICT

Answer 4

Supportive and palliative care indicators tool - helps identify declining health to help plan future care
Is system specific I.e separate indicators for cancer, dementia, frailty, neuro, vascular, kidney, liver, respiratory

Question 5

Describe the 3 types of health decline

Answer 5

Slow decline - frailty
Sudden death predictable - cancer
General decline with exacerbations increasing in frequency and severity - COPD, CKD

Question 6

Features of effective goals

Answer 6

Specific
Measurable
Achievable
Timeframe - when to review progress?

Question 7

What is discussed with advanced care planning in terms of palliation

Answer 7

Preferred place of care
Advance decision to refuse treatment
Lasting power of attorney 
DNA CPR
Advance statement of preference (not legally binding)

Question 8

What framework exists for evidence based guidelines on end of life care

Answer 8

Gold standards framework