Advance care planning paves way for geriatrics nurses to support person-centered care for older adults

Abstract

This past summer was a season of rules for geriatrics healthcare professionalsdand while that might not strike excitement in the heart of kids who are less-than-thrilled to be headed backto school, it’s something we’ve met with tremendous enthusiasm at the American Geriatrics Society (AGS) and across geriatrics. Here’s one reason why. With the release earlier this year of the 2016 Medicare Physician Fee Schedule Proposed Ruleda tool that impacts advanced practice nurses, geriatricians, and all providers eligible to bill on the fee scheduledan important service, Advance Care Planning (ACP), has moved that much closer to recognition long championed by the AGS and a cadre of other stakeholders. ACP is a comprehensive, ongoing, person-centered approach to communication about future healthcare choices. As already implemented by health practitioners and coordinated care teams across the U.S., ACP involves ongoing discussions between healthcare professionals and patients regarding end-of-life preferences and expectations. Often, these voluntary consultations also include family members and caregivers who may serve as proxy decision makers when someone is no longer able to make personal healthcare choices. And in studyafter study, ACP also is increasingly seen as a staple service for frail and aging patients: In a prospective randomized clinical trial of a coordinated approach to ACP in Australia, family members of nearly 90% of participants who received ACP services reported that their loved one’s end-of-life wishes were known and followed. 1 In