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Advance healthcare planning – beyond DNR

26 September 2015

As a healthcare professional, you often see patients placed in situations where they are unable to express their wishes in regards to their healthcare. Whether this inability to respond is due to age, terminal illness or emergency, patients who have previously made their family and emergency contacts aware of their wishes, are most likely to receive the treatment they do – or don’t – want.

Advance healthcare planning lets people declare their healthcare wishes for the future – including when to sustain various life prolonging treatments, and when to decline further treatment.

In your exposure to these treatments in your day-to-day work in the health industry, you probably have a strong idea of the treatments you would personally accept or refuse, and under which circumstances. So you understand how important these decisions are to the families you work with, and how stressful it can be to think your choices aren’t what your loved one wants.

The importance of an advance healthcare plan

An advance healthcare plan is an incredibly important document for your patients – and you personally – to consider writing. It means an individual will only be administered health care treatment that they have previously agreed to, should they be unable to make the decision when the time comes.

Sharon Neyland, Austin Health’s Advance Care Planning Department Project Officer, provides more information about how to talk to your patients about advanced care planning.

Whatever you or your patients’ views – and hence decisions – on life prolonging treatment in a variety of contexts (such as severity of illness or injury, expected quality of life after treatment, length of time receiving the treatment and likelihood of recovery to an independent state), an advance healthcare plan ensures your wishes will be respected. This peace of mind is a great comfort for many people and their families.

Creating an advance healthcare plan

For a patient, creating an advance healthcare plan is a process of reflecting on their own health, values and opinions and putting these into practical steps before they become unable to communicate their desires.

Ideally, a patient will make their advance healthcare plan after discussions with both you, other relevant healthcare professionals and their family. This ensures there is adequate discussion surrounding what is best for them medically and from a quality of life perspective. It also allows those who will have the responsibility to make potentially tough decisions to not only know for certain what the person wants, but any particular reasoning behind their choices.

As a healthcare professional, you can advise a patient to make sure they are aware of all benefits or side effects of their options, but ultimately it is your patient’s decision what treatments or conditions to include in the final plan.

While an advance care plan is a legal document, a lawyer is only required to officiate it if the patient is also appointing a power of attorney to then be their decision-maker. This is separate from the advance healthcare plan.

Once signed and dated by the patient and their witness, copies of the plan are given to those who would need to enact it – family, doctors, and frequently visited hospitals.

Healthcare management

During your time providing healthcare, you probably have already witnessed the distress of families trying to make decisions about their loved ones in difficult moments.  Not only do you understand the importance of creating an advance healthcare plan, but also the necessity for the facilities and resources to be able to provide the care your patient want.

The trends for the future of healthcare suggest that there will be more collaboration between different sectors of healthcare – this too will apply to the provisions available to carry out advance healthcare plans.

Empower and educate

Imagine how much anxiety around making the wrong decision you could save for patients’ family members if you could encourage more of the population to have an ongoing discussion about their advance healthcare plans. An advance healthcare plan is much more about ensuring people are prepared for the future than reacting when confronted with decision-making.

A Master of Healthcare Leadership will help you develop the skills you need to help educate the community and patients in your facility or department around the importance of creating an advanced healthcare plan before they need to use it. You could advise a local or wide-reaching campaign on the importance of preparation, or even influence policy surrounding the responsibility of enacting an advance healthcare plan.

For more information about how you could use your skills from an Online Master of Healthcare Leadership, speak to one of our Student Enrolment Advisors. We’re available Monday – Friday on 1300 589 882.