Importance of the Advance Care Planning Discussion (Part I)

Editor’s Note: This post is the first in a two-part series about the importance of discussing a patient’s wishes during the advance care planning process. The first part speaks more to doctors, nurses and caregivers while the second part will be directed to patients and families.

The question is often asked, “Isn’t a signed Power of Attorney for Healthcare enough?” The answer is no! Signing the document without a discussion about the patient’s values, beliefs, and wishes is only a task half done.

A facilitated discussion that asks, “What do you think?” and “What do you wish?” gives both the patient and the facilitator an opportunity to reach a comfort level with each other that allows deeper questions to be asked and considered.

A level of trust develops and the patient may be able to express concerns or ask questions that had not previously been revealed.  Involving the patient’s family in this discussion will deepen their relationships as they explore this territory together.

In his book, “The Best Care Possible,” Dr. Ira Byock states, “The best care possible comes from understanding what makes people tick, what their values are, and how those values apply to care.”

Right or Wrong?

There are no wrong answers.  These discussions are about our patients as individuals.  All of their answers and their underlying belief structures are right!  Some beliefs based on misinformation may need clarification or further education but their opinions and feelings are valid within the framework of their understanding.  Increasing their knowledge or understanding of the decisions available to them is essential if they are to be able to ask the questions they need answers to when talking with their care providers.

Talk to Your Patients!

Initiate meaningful discussions and note the answers.  Your care of and for your patients and their families will benefit with your deepened understanding of who they are as individuals and how they function as a family unit.  Your patients and their families will benefit through knowledge of the decisions that they may be in their future.  Finally, care provided at end of life will improve as healthcare providers recognize the desires of the unique individuals for whom they have the privilege of and responsibility for serving.

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