Abstract
BackgroundAdvance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person’s values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers.MethodsAn invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample.Results120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client’s wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service.ConclusionsThis survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-015-0018-y) contains supplementary material, which is available to authorized users.
Highlights
Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person’s values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions
Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person’s values, beliefs and treatment preferences are made known so they can guide clinical decision making at a future time when that person cannot make or communicate their decisions due
In Australia since the early 1990’s, home care services have been available as an alternative to living in a Residential aged care facility (RACF) for older persons with complex care issues who would prefer to live in their own home
Summary
Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person’s values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person’s values, beliefs and treatment preferences are made known so they can guide clinical decision making at a future time when that person cannot make or communicate their decisions due Sellars et al BMC Palliative Care with care, as well as reduced stress, anxiety and depression in surviving relatives [4,5,6,9]. HCP clients are assigned a case manager who, in collaboration with the client and family, coordinates and reviews the care services that clients receive under the funding allocated to the HCP [10]
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