Clinical
Advance care planning
This is a summary of the peer-reviewed article: Incorporating advance care planning in dementia care by Dionysios Giotas and Karen Harrison Denin.
The article discusses advance care planning (ACP) as a proactive process that allows people with dementia to describe their preferences for future medical treatment and care. ACP encompasses various components, such as appointing a lasting power of attorney, creating an advance decision to refuse treatment and specifying a preferred place of care and/or death
This is a summary of the peer-reviewed article: Incorporating advance care planning in dementia care by Dionysios Giotas and Karen Harrison Dening
The article discusses advance care planning (ACP) as a proactive process that allows people with dementia to describe their preferences for future medical treatment and care. ACP encompasses various components, such as appointing a lasting power of attorney, creating an advance decision to refuse treatment and specifying a preferred place of care and/or death.
Importance of advance care planning in dementia care
- ACP is central to providing person-centred care that respects the individual’s preferences and enhances their quality of life.
- Properly executed ACP can reduce the risk of unnecessary interventions that do not align with the person’s desires, particularly in the later stages of dementia.
- ACP provides clarity and guidance for family members and carers.
When to discuss advance care planning
Early stage
- ACP should ideally be initiated soon after a dementia diagnosis, as the person typically still has the mental capacity to make informed decisions.
- The discussion can be started by a consultant, GP or dementia nurse specialist during regular appointments or health screenings.
- Early planning allows the individual to express their wishes and preferences, ensuring that these are followed as their condition progresses.
Progressing stage
- ACP should be revisited as the person’s care needs increase, marking a transition in their condition.
- Transition points may include moving to a care home or returning home from a hospital stay after a significant health event.
- Reviewing ACP at these points helps to adjust the care plan according to the person’s evolving needs and ensures continuity of care.
Later stage
- As dementia advances and mental capacity diminishes, it is critical to review any existing ACP.
- Family members and carers have a crucial role at this later stage, especially if the person is unable to communicate their wishes.
- Ensuring that the ACP is up to date can prevent unnecessary hospital admissions and unwanted medical interventions, aligning care with the person’s wishes.
Related articles
- RELATED: Advance care planning and decision-making in dementia care: a literature review
- RELATED: Exploring whether a diagnosis of severe frailty prompts advance care planning and end of life care conversations