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Advance Care Planning

Advance Care Planning  

Emily Chai, Diane Meier, Jane Morris, and Suzanne Goldhirsch

in Geriatric Palliative Care

Print Publication Year: 
Apr 2014
Series: 
Other
Published Online: 
Nov 2014
eISBN: 
9780199390762
DOI: 
10.1093/med/9780195389319.003.0008
Career: 
Doctor, Qualified, specialist, Qualified, late specialism training, Nurse, Qualified Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Geriatric Medicine
Item type: 
chapter
ISBN: 
9780195389319
decisional capacity. 4 . Translating the individual’s expressed care preferences into an advance directive document (e.g., Health Care Proxy or Living Will). 5 . Health care providers are made aware of existence of ACP documents; written plans are stored and retrievable. 6 . Advance care plans are updated and should become more specific in the event of a change in health status or modification of goals for care . Exploring Preferences and Establishing Goals for Care Advance care planning can be discussed in the outpatient setting, where the main focus
Advance care planning (ACP)

Advance care planning (ACP)  

Miriam Johnson, Karen Hogg, James Beattie, and Max Watson

in Heart Failure (Oxford Specialist Handbooks in End of Life Care): From Advanced Disease to Bereavement

Print Publication Year: 
May 2012
Series: 
Oxford Specialist Handbooks, OSHs in End of Life Care
Published Online: 
Jul 2012
eISBN: 
9780191740787
DOI: 
10.1093/med/9780199299300.003.0045
Career: 
Doctor, Qualified, early specialism training, Qualified, late specialism training, Qualified, specialist, Nurse, Qualified Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Cardiovascular Medicine
Item type: 
chapter
ISBN: 
9780199299300
Chapter 8 Advance care planning (ACP) Introduction Introduction 104 Power of attorney (POA) Power of attorney (POA) 108 ACP and the medical management plan ACP and the medical management plan 110 Introduction ACP is a voluntary process whereby patients can express their preferences and goals for future care in advance of the event that they lose capacity. It is a valuable way for enhancing communication within a group of patients for whom competence for decision-making may decline with increasing frailty and disease progression. Exploring preferences for future
Advance Care Planning

Advance Care Planning  

Jeanine Blackford and Annette F. Street

in Textbook of Palliative Care Communication

Print Publication Year: 
Oct 2015
Series: 
Other
Published Online: 
Oct 2015
eISBN: 
9780190201739
DOI: 
10.1093/med/9780190201708.003.0035
Career: 
Doctor, Qualified, early specialism training, Qualified, late specialism training, Qualified, specialist
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Communication Skills
Item type: 
chapter
ISBN: 
9780190201708
context of advance care planning . Palliat Support Care . 2012;10(02):75–82. 22. Dempsey D. Advance care planning for people with dementia: Benefits and challenges. Int J Palliat Nurs . 2013;19(5):227–234. 23. Colman RE , Curtis JR , Nelson JE , et al. Barriers to optimal palliative care of lung transplant candidates. Chest . 2013;143(3):736–743. 24. Gott M , Gardiner C , Small N , et al. Barriers to advance care planning in chronic obstructive pulmonary disease. Palliat Med . 2009;23(7):642–648. 25. Heffner JE. Advance care planning in chronic
Principles of Advance Care Planning

Principles of Advance Care Planning  

Donna S. Zhukovsky

in Internal Medicine Issues in Palliative Cancer Care

Print Publication Year: 
Apr 2015
Series: 
Other
Published Online: 
May 2015
eISBN: 
9780199375066
DOI: 
10.1093/med/9780199329755.003.0003
Career: 
Doctor, Qualified, specialist, Qualified, late specialism training
Specialty: 
Clinical Medicine, Palliative Medicine, Radiology, Clinical Oncology
Item type: 
chapter
ISBN: 
9780199329755
physician. Figure 3.1 Advance care planning involves longitudinal discussions between the patients and clinicians to find a balance between patient preferences and realistic medical options. Communication of Advance Care Plans and Advance Directives • Communication of advance care plans occurs as part of the ACP process when key stake holders are involved: • The patient • His or her surrogate decision maker • Family and other loved ones • Involved clinicians • Accessibility of advance care plans to the healthcare team is
Advance care planning for older people

Advance care planning for older people  

Aline De Vleminck and Luc Deliens

in Oxford Textbook of Geriatric Medicine (3 ed.)

Print Publication Year: 
Dec 2017
Series: 
Oxford Textbooks
Published Online: 
Dec 2017
eISBN: 
9780191807190
DOI: 
10.1093/med/9780198701590.003.0160
Career: 
Doctor, Qualified, early specialism training, Qualified, late specialism training, Qualified, specialist, Nurse
Specialty: 
Clinical Medicine, Geriatric Medicine
Item type: 
chapter
ISBN: 
9780198701590
& Kelner, M. (1999). Quality end-of-life care : patients’ perspectives. JAMA , 281, 163–8. Sudore, R. L. & Fried, T. R. (2010). Redefining the ‘ planning ’ in advance care planning : preparing for end-of-life decision making. Ann Intern Med , 153, 256–61. Teno, J. (2003). Advance care planning for frail, older persons. In: Morrison, R. S. , Meier, D. E. (eds). Geriatric Palliative Care , pp. 307–13. Oxford, UK: University Press. Thomas, K. & Lobo, B. (2011). Advance Care Planning in End of Life Care . Oxford, UK: Oxford University Press. Thompson
Advance Care Planning and Surrogate Decision-Making

Advance Care Planning and Surrogate Decision-Making  

Robert C. Macauley

in Ethics in Palliative Care: A Complete Guide

Print Publication Year: 
Mar 2018
Series: 
Other
Published Online: 
Apr 2018
eISBN: 
9780190652357
DOI: 
10.1093/med/9780199313945.003.0003
Career: 
Doctor, Qualified, specialist
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Ethics
Item type: 
chapter
ISBN: 
9780199313945
Hospice and Palliative Care Organization . (2015). Hospice care in America. Retrieved from https://www.nhpco.org/sites/default/files/public/Statistics_Research/2015_Facts_Figures.pdf National POLST Paradigm . (2017). POLST and advance directives. Retrieved from http://polst.org/ advance - care - planning /polst-and- advance -directives/ Nelson, J. E. , Angus, D. C. , Weissfeld, L. A. , Puntillo, K. A. , Danis, M. , Deal, D. , . . . Cook, D. J. (2006). End-of-life care for the critically ill: A national intensive care unit survey. Crit Care Med , 34 (10), 2547–2553
Advance Care PlanningAdvance Directives, Medical Order Sets, and Surrogate Decision Making

Advance Care Planning: Advance Directives, Medical Order Sets, and Surrogate Decision Making  

Debra L. Wiegand and Katherine A. Hinderer

in Advanced Practice Palliative Nursing

Print Publication Year: 
Feb 2016
Series: 
Other
Published Online: 
Apr 2016
eISBN: 
9780190204761
DOI: 
10.1093/med/9780190204747.003.0039
Career: 
Nurse, Qualified Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Nursing Skills
Item type: 
chapter
ISBN: 
9780190204747
APRN and healthcare team. 4 Using the transtheoretical model of change as a framework, stages of behavior in advance care planning may include (1) pre-contemplation (the patient has not thought about advance care planning ), (2) contemplation (the patient is thinking about advance care planning ), (3) preparation (the patient is planning to participate in advance care planning ), (4) action (the patient has had discussions and is engaged in advance care planning ), and (5) maintenance (the patient has completed documents like a living will or has formally designated a durable
Communication Challenges in Providing Advance Care Planning for People Living With HIV/AIDS

Communication Challenges in Providing Advance Care Planning for People Living With HIV/AIDS  

Maureen E. Lyon, Blaire Schembari, Brittney Lee, and Peter Selwyn

in Textbook of Palliative Care Communication

Print Publication Year: 
Oct 2015
Series: 
Other
Published Online: 
Oct 2015
eISBN: 
9780190201739
DOI: 
10.1093/med/9780190201708.003.0024
Career: 
Doctor, Qualified, early specialism training, Qualified, late specialism training, Qualified, specialist
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Communication Skills
Item type: 
chapter
ISBN: 
9780190201708
controlled trial of advance care planning for teens with cancer: Anxiety, depression, quality of life, advance directives, spirituality. J Adolesc Health . 2014;54(6):710–717. 52. Lyon ME , Jacobs S , Briggs L , Cheng YI , Wang J. Family centered advance care : Planning for teens with cancer. JAMA Pediatr . 2013;167(5):460–467. 53. Longitudinal Pediatric Palliative Care : Quality of Life & Spiritual Struggle http://clinicaltrials.gov/show/NCT01289444 and Palliative Care with Persons Living with AIDS: Integrating into Standard of Care http://clinicaltrials
How to deliver the best supportive and palliative care

How to deliver the best supportive and palliative care  

Edwina Brown, Fliss Murtagh, Emma Murphy, and Max Watson

in Kidney Disease (Oxford Specialist Handbooks in End of Life Care): From advanced disease to bereavement (2 ed.)

Print Publication Year: 
May 2012
Series: 
Oxford Specialist Handbooks, OSHs in End of Life Care
Published Online: 
Jul 2012
eISBN: 
9780191740916
DOI: 
10.1093/med/9780199695690.003.0009
Career: 
Doctor, Qualified, early specialism training, Qualified, late specialism training, Qualified, specialist, Nurse, Qualified Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Nephrology
Item type: 
chapter
ISBN: 
9780199695690
Organization. Advance care planning Advance care planning What is it? There is often some confusion between advance care planning and advance directives or statements. Advance care planning is planning ahead to anticipate care , and is particularly important when health is declining towards death. Without good advance care planning , a crisis will arrive, and decisions may be made in the heat of crisis which do not concur with the patients priorities and preferences, Best practice in advance care planning includes: • Discussing preferences and priorities for care with patient
The Advanced Practice Registered Nurse in Primary Care

The Advanced Practice Registered Nurse in Primary Care  

Rosemary Gorman and Dorothy Wholihan

in Advanced Practice Palliative Nursing

Print Publication Year: 
Feb 2016
Series: 
Other
Published Online: 
Apr 2016
eISBN: 
9780190204761
DOI: 
10.1093/med/9780190204747.003.0014
Career: 
Nurse, Qualified Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Nursing Skills
Item type: 
chapter
ISBN: 
9780190204747
rates of advance directives in primary care include improved reimbursement, increased patient awareness, and educational efforts geared to improving communication skills among providers. Chapter Chapter 39 Advance Care Planning 39 discusses advance directives. Box Box 14.3 Educational Resources for Advance Care Planning Discussions in Primary Care 14.3 lists educational resources available to facilitate advance care planning discussions in primary care settings. Box 14.3 Educational Resources for Advance Care Planning Discussions in Primary Care
Can we reduce the need for coercive interventions?

Can we reduce the need for coercive interventions?  

George Szmukler

in Men in White Coats: Treatment Under Coercion

Print Publication Year: 
Nov 2017
Series: 
Other
Published Online: 
Dec 2017
eISBN: 
9780191840227
DOI: 
10.1093/med/9780198801047.003.0010
Career: 
Doctor, Qualified, late specialism training
Specialty: 
Psychiatry, Forensic Psychiatry
Item type: 
chapter
ISBN: 
9780198801047
time and thus to reduce the need for coercive measures. Advance statements in psychiatry vary along a number of dimensions: whether the process for arranging the ‘ advance statement’ is patient or service-provider led; whether the stated preferences are legally binding or not; and whether its construction is facilitated by a person independent of the clinical team. At least three major types of advance statement have been used in mental health care : ‘crisis cards’, ‘joint crisis plans ’, and ‘psychiatric advance directives’. Crisis cards In a ‘crisis card’
End of life care in advanced kidney disease

End of life care in advanced kidney disease  

Althea Mahon, Karen Jenkins, and Lisa Burnapp

in Oxford Handbook of Renal Nursing

Print Publication Year: 
Jun 2013
Series: 
Oxford Handbooks in Nursing
Published Online: 
Jul 2013
eISBN: 
9780191742682
DOI: 
10.1093/med/9780199600533.003.0016
Career: 
Nurse, Qualified Nurse, Trainee Nurse
Specialty: 
Medical Skills, Nursing Skills, Clinical Medicine, Nephrology
Item type: 
chapter
ISBN: 
9780199600533
trigger conversations with patients/ carers to aid advanced care planning • Answering no to the ‘surprise question’, i.e. would you be surprised if this person died in the next 6 months, is an indication that EOL care planning should be discussed • It promotes a consistent and proactive approach in supporting patients and links with the palliative care registers held by GP practices. Advanced care planning • Dialysis patients should be given the opportunity to discuss their wishes regarding cessation of dialysis in advance • Many die unprepared despite
End-of-Life Decision-Making

End-of-Life Decision-Making  

Chad D. Kollas and Beth Boyer Kollas

in Geriatric Forensic Psychiatry: Principles and Practice

Print Publication Year: 
Nov 2017
Series: 
Other
Published Online: 
Dec 2017
eISBN: 
9780190856489
DOI: 
10.1093/med/9780199374656.003.0012
Specialty: 
Psychiatry, Old Age Psychiatry, Forensic Psychiatry
Item type: 
chapter
ISBN: 
9780199374656
Advance Care Planning : A Tool for End-of-Life Decision-Making in the Elderly Advance care planning is a process by which patients may make their preferences regarding certain types of treatment or medical care , especially life-support measures, known in advance of their need for those services. 25 In this process, healthcare professionals must work to assess and understand patient preferences for care through ongoing discussions with capacitated adult patients and/or their family members or surrogates. Overall, the key purpose of advance care planning is to
Palliative care in the UK

Palliative care in the UK  

Nancy Preston and Katherine Froggatt

in Oxford Textbook of Palliative Nursing (4 ed.)

Print Publication Year: 
Jan 2015
Series: 
Oxford Textbooks, Oxford Textbooks in Palliative Medicine
Published Online: 
Jan 2015
eISBN: 
9780199385225
DOI: 
10.1093/med/9780199332342.003.0074
Career: 
Nurse, Qualified Nurse, Trainee Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Nursing Skills
Item type: 
chapter
ISBN: 
9780199332342
2010;88(2):211–239. 45 . Stein GL , Fineberg IC. Advance care planning in the U.S. and U.K.: a comparative analysis of policy, implementation, and the social work role. Br J Soc Work. 2013. doi: 10.1093/bjsw/bct013vb 46 . Samanta A , Samanta J. Advance care planning : the role of the nurse. Br J Nurs. 2010;19(6):1060–1061. 47 . National End of Life Care Programme . Capacity, Care Planning and Advance Care Planning in Life Limiting Illness: A Guide for Health and Social Care Staff. National End of Life Care Programme, 2011. Available from: http://www.endof
Long-Term Care: Focus on Nursing Homes

Long-Term Care: Focus on Nursing Homes  

Joan G. Carpenter and Mary Ersek

in Structure and Processes of Care

Print Publication Year: 
Jan 2015
Series: 
HPNA Palliative Nursing Manuals
Published Online: 
Apr 2015
eISBN: 
9780190223779
DOI: 
10.1093/med/9780190223755.003.0006
Career: 
Nurse, Qualified Nurse, Allied Health Professional, Qualified AHP
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Nursing Skills, Radiology, Clinical Oncology
Item type: 
chapter
ISBN: 
9780190223755
Teams External palliative care consultation teams provide specialized services in nursing homes and make recommendations for the resident’s care . Consultation teams can be an extension of existing hospital-based teams, outpatient teams, or independent practitioners. Depending on the team and resources, consultations may focus on symptom management, advance care planning , or assisting with prognostication and/or hospice entry. Need for a consult is typically identified by staff or leadership, then formally requested by the primary care provider. The consultant bills
Palliative care and end-of-life care

Palliative care and end-of-life care  

Elizabeth L. Sampson and Karen Harrison Dening

in Mental Health and Care Homes

Print Publication Year: 
May 2011
Series: 
Other
Published Online: 
Feb 2013
eISBN: 
9780191754722
DOI: 
10.1093/med/9780199593637.003.0021
Career: 
Doctor, Qualified, early specialism training, Undergraduate Doctor
Specialty: 
Psychiatry
Item type: 
chapter
ISBN: 
9780199593637
Royal College of General Practitioners. Advance Care Planning . Concise Guidance to Good Practice series, No. 12. London: RCP, 2009 (available from http://bookshop.rcplondon.ac.uk/details.aspx?e=267 ) Advance care planning Advance care planning (ACP) is understood in a variety of different ways. The term is often used without definition or explanation and different emphases are placed upon the different elements of the care planning . The discussion and process of formulating an advance care plan may be more valued than the final document that is produced.
The Overlap of Palliative Care and Critical Illness

The Overlap of Palliative Care and Critical Illness  

Aluko A Hope and Judith E Nelson

in Textbook of Post-ICU Medicine: The Legacy of Critical Care

Print Publication Year: 
May 2014
Series: 
Other
Published Online: 
Jul 2014
eISBN: 
9780191780653
DOI: 
10.1093/med/9780199653461.003.0005
Career: 
Doctor, Qualified, specialist, Qualified, late specialism training, Qualified, early specialism training
Specialty: 
Critical Care
Item type: 
chapter
ISBN: 
9780199653461
manage the ongoing challenges. Aligning care with patient values and preferences: advance care planning The typical patient with acute critical illness is too cognitively impaired to participate in planning for future care . 72 , 73 Among those whose critical illness becomes chronic, few have prepared an advance directive, and the vast majority have not even appointed a health care proxy to make surrogate decisions. 74 Recovery from critical illness, however, may provide an opportunity for advance care planning by the ICU survivor, who remains at medical risk
Palliative care in Canada

Palliative care in Canada  

Doris Howell and Ann Syme

in Oxford Textbook of Palliative Nursing (4 ed.)

Print Publication Year: 
Jan 2015
Series: 
Oxford Textbooks, Oxford Textbooks in Palliative Medicine
Published Online: 
Jan 2015
eISBN: 
9780199385225
DOI: 
10.1093/med/9780199332342.003.0072
Career: 
Nurse, Qualified Nurse, Trainee Nurse
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Nursing Skills
Item type: 
chapter
ISBN: 
9780199332342
trajectory with palliative care needs. The adoption of a palliative care approach is also considered to be fundamental to ensuring access to palliative care in long-term care facilities in Canada. The CHPCA in partnership with the Quality Palliative Care in Long Term Care Alliance (QPC-LTC) aims to develop the capacity for high-quality care in long-term care facilities to reach the following goals: expand advance care planning uptake in long-term care , enhance resources to allow long-term care facilities to create hospice palliative care programs, strengthen inte
Palliative care in end-stage renal disease

Palliative care in end-stage renal disease  

Katie Vinen, Fliss E. M. Murtagh, and Irene J. Higginson

in Oxford Textbook of Clinical Nephrology (4 ed.)

Print Publication Year: 
Oct 2015
Series: 
Oxford Textbooks
Published Online: 
Oct 2015
eISBN: 
9780191779145
DOI: 
10.1093/med/9780199592548.003.0146
Career: 
Doctor, Qualified, specialist, Qualified, early specialism training
Specialty: 
Clinical Medicine, Nephrology, Surgery
Item type: 
chapter
ISBN: 
9780199592548
research is followed and patients do have honest discussions in the pre-dialysis setting, then ongoing advance care planning in the haemodialysis setting should follow more easily ( Davison and Torgunrud, 2007 ). Many believe that, as a minimum, advance care planning should start when the answer to the surprise question is ‘no’. Advance care planning should be reviewed at least annually and after any significant change in a patient’s health. Whilst advance care planning may be poorly defined, research suggests it is highly valued by patients ( Davison, 2006 ) although
Palliative Social Work in the United Kingdom

Palliative Social Work in the United Kingdom  

Malcolm Payne and Margaret Reith

in Oxford Textbook of Palliative Social Work

Print Publication Year: 
Apr 2011
Series: 
Oxford Textbooks, Oxford Textbooks in Palliative Medicine
Published Online: 
Oct 2012
eISBN: 
9780199975143
DOI: 
10.1093/med/9780199739110.003.0064
Career: 
Doctor, Undergraduate Doctor, Allied Health Professional, Trainee AHP, Qualified AHP
Specialty: 
Clinical Medicine, Palliative Medicine, Medical Skills, Communication Skills, Community Medical Services
Item type: 
chapter
ISBN: 
9780199739110
and program planning , this has become an important objective of social care services. Increasingly, therefore, creative arts are used in palliative care services, and this may be extended to social work, which can help clients record life histories, undertake creative writing, and use memory boxes to build interpersonal relationships with relatives that will maintain continuing bonds after bereavement ( Reith & Payne , 2009 ). Advance Care Planning The development of advance care planning has emerged from a number of initiatives. Palliative care services have

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