Irish Hospice Foundation
Toolkit for Compassionate End-of-Life Care
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Advance care planning should be started as early as a possible, ideally while a person is still very well. However, it is especially important if and when: • e person has a life-limiting, progressive illness. • e person’s treatment preferences differ from the advice of their healthcare team. • ere is a significant deterioration in the person’s condition. • A treatment decision needs to be made. • At the time of referring to Specialist Palliative Care services. • You can answer ‘no’ to the surprise question ‘ Would you be surprised if this person dies within 12 months?’
Having an advance care planning conversation Some people may not be ready or willing to have a conversation about their future care, and if this is the case, then you should respect their wishes not to. You can let them know that
“We want to understand what is important to
this is something that can be revisited another time and you will be happy to chat to them more as and when they wish. “I am very happy to talk to you about any concerns or questions you have about this now or later. Is there anything you would like to ask me about?” A nice way to introduce the concept of ACP is: “Often people with conditions like yours have a lot of questions that are sometimes scary or sometimes they are not certain if they want to know the answers. People vary in how they want to make medical decisions and plan for future care. Some people want to do this themselves, some want to share this with the doctor. What would you like?”
you so that we can care for you in a way that you want us to. Have you thought about how you would want us to care for you if you become very sick, and are unable to tell us what you would want?”
Some people also might want to have relatives and friends be a part of the discussion. Don’t make assumptions. Ask “Is there anyone you would like to include in this conversation?” Establish how much the person understands about their medical condition – “What is your understanding of where you are with your health?”
Find out what matters most to the person: • “What is important to you?”
• “What does a good day look like for you?” • “What are your goals and priorities?” • “What would you be willing to sacrifice or not sacrifice?” Find out if there is anything worrying the person: • “What are your biggest concerns at the moment?” • “What are your worries about your future?”
Asking open-ended questions will encourage a conversation to flow . Remember to use your communication skills, use an inviting tone and open body language. Encourage the person to ask questions and offer to support them with communicating the conversation with any person or people to whom they have given their consent for this purpose.
Preparation 3
End-of-Life Care Planning and
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