Learning Outcome 1: Understand the principles of advance care planning
1.1. Describe the difference between a care or support plan and an Advance Care Plan
Advance care planning (ACP) is a process of discussion between an individual and their care providers irrespective of discipline. According to NHS guidlines the difference between ACP and planning more generally-which sets out how the client's care and support needs will be met- is that the process of ACP is to make clear a person’s wishes. 1.2. Explain the purpose of advance care planning
It usually take place in the context of an anticipated deterioration in the individual’s condition in the future, with attendant loss of capacity to make decisions and/or ability to communicate wishes to others. In that case Advance care planning can ensure that all of those concerned with the patient’s care and well-being kept informed -with the patient’s permission-of any decisions, wishes or preferences which impact upon her care when she has no ability to communicate these any more.
1.3. Identify the national, local and organisational agreed ways of working for advance care planning
The main principles are covering the agreed ways of working:
The process is voluntary. No pressure should be brought to bear by the professional, the family or any organisation on the individual concerned to take part in ACP ACP must be a patient centred dialogue over a period of time The process of ACP is a reflection of society’s desire to respect personal autonomy. The content of any discussion should be determined by the individual concerned. The individual may not wish to confront future issues; this should be respected All health and social care staff should be open to any discussion which may be instigated by an individual and know how to respond to their questions Health and social care staff should instigate ACP only if in the context of a professional judgement that leads them to believe it is likely to benefit the care of the individual. The discussion should be introduced sensitively Staff will require the appropriate training to enable them to communicate effectively and to understand the legal and ethical issues involved Staff need to be aware when they have reached the limits of their knowledge and competence and know when and from whom to seek advice Discussion should focus on the views of the individual, although they may wish to invite their carer or another close family member or friend to participate. Some families may have discussed their issues and would welcome an approach to share this discussion Confidentiality should be respected in line with current good practice and professional guidance Health and social care staff should be aware of and give a realistic account of the support, services and choices available in the particular circumstances. This should entail referral to an appropriate colleague or agency when necessary The professional must have adequate knowledge of the benefits, harms and risks associated with treatment to enable the individual to make an informed decision Choice in terms of place of care will influence treatment options, as certain treatments may not be available at home or in a care home, e.g. chemotherapy or intravenous therapy. Individuals may need to be admitted to hospital for symptom management, or may need to be admitted to a hospice or hospital, because support is not available at home ACP requires that the individual has the capacity to understand, discuss options available and agree to what is then planned. Should an individual wish to make a decision to refuse treatment (advance decision) they should be guided by a professional with appropriate knowledge and this should be documented according to the requirements of the MCA 2005
1.4. Explain the legal position of an Advance Care Plan
Mental Capacity Act 2005 which came into force in October 2007 along with the supporting Code of...
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