Introduce and explain advance care planning
Introducing advance care planning can be challenging. It is best done when a person is healthy, before there is an urgent need for it. When people are prepared, outcomes are better, stress is reduced and healthcare providers report greater professional satisfaction.
Getting started
People’s readiness to engage in advance care planning will vary and conversations may happen over multiple visits.
Consider the following:
- For many people you will need to start by introducing and normalizing the concept.
- Highlight its importance using benefits that resonate with the individual.
- Offer resources so they can learn more on their own time, at their own pace.
- Reassure them that questions or concerns can be discussed in future visits.
Benefits of advance care planning
Advance care planning has many benefits for:
The person
- Better prepared for medical decision-making
- Improved illness understanding and prognostic awareness
- Greater satisfaction with care
Family members and agent(s)
- Reduced decision-making burden
- Decreased anxiety, depression, complicated grief
- Greater satisfaction with care
Healthcare providers
- Improved collaboration and transitions in care
- Decreased distress
- Greater satisfaction with care
When to talk about it
Watch for opportunities in regular encounters. Pay attention to cues and questions raised by the person. You may also wish to link it to routine clinical practices, such as an annual visit.
Also consider building the following triggers into your practice:
- a hospital admission
- a specialist visit
- decreasing functional status
- an advancing/worsening illness or condition
- 65 years of age or older
- transitioning to a new care environment
- at risk of losing capacity to make treatment decisions
Example conversation starters
Healthy adults
Before we finish up today, I've been asking people if they have ever heard of something called advance care planning. Can I tell you a bit about it?
Advance care planning prepares you and others to make important decisions about your care. Thinking and talking about what matters to you in advance can make a difficult time easier for you and the people close to you.
Would you be interested in learning more?
People living with illness
Today we’ve talked about your [illness/condition]. Before we finish up today, I would like to take a step back to talk about something called advance care planning. Has anyone ever talked to you about this?
Advance care planning prepares you and others to make important decisions about your care. Thinking and talking about what matters to you in advance can make treatment decisions easier for you and the people close to you. It allows everyone to understand your goals and preferences and who you would like to make decisions for you if you’re not able to make them yourself.
Can I offer you some resources to take home? We can discuss any questions you have at your next visit.
What if someone isn't interested?
- That’s okay. After you introduce the idea of advance care planning, listen to how they respond. Even if they don't want to talk about it now, they may be open to it in the future.
- Keep in mind, a person may be the agent for someone else in their life, making this information relevant to them in another way.