Advance Care Planning (ACP)
ACP is the process of clarifying patient-centered goals for future health care that are consistent with individual culture, values, and lifestyle. The process of setting these goals can occur over time and the goals may even change over the course of an illness. Patients with serious illness and their caregivers are often faced with difficult and at times overwhelming decisions. Open and honest communication among providers, patients, and their caregivers about the illness and how it may progress can help with informed decision making. It is also important to educate patients about available treatment options and what their experience of those treatments may be. For some patients, the potential side effects of more disease-focused treatments may prove to be unacceptable, especially if their goal is better quality of life. For others, the risk of these side effects may not be a deterrent.
ACP also includes completion of Advance Directives. These are the legal documents that specify, in advance, specific patient wishes.
A Health Care Proxy is a document that allows a person to designate a surrogate decision maker in the event they are no longer able to speak for themselves.
A Do Not Resuscitate Order states that no efforts should be made to revive someone whose heart and breathing have stopped.
A Living Will can indicate treatment preferences. For a more complete review of the ACP process, including Advance Directives, refer to any of the websites below. Refer to a Palliative Care Specialist for complex medical and/or psychosocial cases.
Additional Resources
Helpful Web Sites
- Compassion and Support
- Oncotalk
- Vitaltalk
- MD Anderson
- Palliative Care and the Human Connection: Ten Steps for What to Do and Say (Youtube video)
- National Center for Ethics in Health Care
References
- Bernacki, R. E., and Block, S. D. “Communication about Serious Illness Care Goals: A Review and Synthesis of Best Practices.” Journal of the American Medical Association Internal Medicine 174 no. 12 (2014): 1994-2003. doi:10.1001/jamainternmed.2014.5271.
- Jackson, V. A., Jacobsen, J., Greer, J. A., Pirl, W. F., Temel, J. S., and Back, A. L. “The Cultivation of Prognostic Awareness through the Provision of Early Palliative Care in the Ambulatory Setting: A Communication Guide.” Journal of Palliative Medicine 16 no. 8 (2013): 894-900.
- Murry, S.A., Kendall, M., Boyd, K., and Sheikh, A. “Illness Trajectories and Palliative Care.” BMJ 330 no. 7498 (2005): 1007-1011.