RT Journal Article
SR Electronic
T1 A future care planning initiative to improve the end of life care of patients on the complex care ward of a district general hospital
JF Future Hospital Journal
JO Future Hosp J
FD Royal College of Physicians
SP 87
OP 89
DO 10.7861/futurehosp.2-2-87
VO 2
IS 2
A1 Debbie Benson
A1 Elena Mucci
YR 2015
UL http://www.rcpjournals.org/content/2/2/87.abstract
AB Medically led, patient-centred, future care planning for patients predicted to be in their last year of life is possible on the complex care ward of an acute hospital, where patients often wait for social care placement into a nursing home. When the patient lacks the mental capacity to engage in the planning discussions themselves, meetings can take place between the multidisciplinary geriatric team and either those close to the patient or an independent mental capacity advocate. Participants in the meeting should use any existing advance care planning information, as appropriate, to develop ‘best interests advice’ (which can be referred to at a later date when a best interests decision needs to be made for the patient). Any future medical care plan should be reviewed for applicability and validity if the person's condition changes (improves or deteriorates), if the patient or those close to the patient request it, or 6–12 months after the initial plan is made. Education, training and support must be provided to ensure acceptance and understanding of the PEACE (PErsonalised Advisory CarE) process and general end of life care in the community. Specialist palliative care services are often best placed to provide this.