In the spirit of the #ACPEL2015 conference coming up soon, I was reminded of this randomised controlled trial done in Australia about the impact of advance care planning.
309 legally competent medical inpatients aged 80 or more were randomised to “normal care” or “normal care plus advance care planning” and followed for six months or until death. The main outcome measure was whether wishes were known and respected in the patients who had died.
Of the 56 patients who died by six months, end of life wishes were much more likely to be known and followed in the intervention group (25/29, 86%) compared with the control group (8/27, 30%; P<0.001). In the intervention group, family members of patients who died had significantly less stress (intervention 5, control 15; P<0.001), anxiety (intervention 0, control 3; P=0.02), and depression (intervention 0, control 5; P=0.002) than those of the control patients. Patient and family satisfaction was higher in the intervention group.
The authors concluded that “Advance care planning improves end of life care and patient and family satisfaction and reduces stress, anxiety, and depression in surviving relatives.”
Thanks for this post Sonia. We know that Advance Care Planning has benefits – now how to improve its uptake? My personal views are that we need to raise community awareness about ACP so that people start having discussions with their loved ones (and health care professionals) about their values, wishes and goals. I think one way to get this happening is to use narrative – stories from people about where ACP has helped, or would have helped, in the care of their loved ones (or themselves). ACP group education sessions in community settings would also be useful…is there a way to infiltrate sporting clubs and the like?
I also love the MyValues website developed by Charlie Corke in Victoria – I have used it myself!
Yes it’s great isn’t it Elissa – here is the link for anyone who is interested