Advanced Care Planning and Dementia

This assignment explores the complex topic of advanced care planning, particularly focusing on its relevance in cases involving dementia. It delves into patient perspectives, family dynamics, and healthcare professionals' roles. A case study illustrating an individual's desire for a peaceful death due to their life goals being fulfilled is analyzed. Discussion questions encourage critical thinking about ethical considerations, communication strategies, and the importance of respecting patients' wishes at end-of-life.

Running head: ADVANCED CARE PLANNING
ADVANCED CARE PLANNING
Name of the Student
Name of the university
Author’s note

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Introduction
At first I would like to introduce myself………………………………
Today I would like to have a small discussion regarding the advanced care planning while
dealing with a patient having dementia. First I would like to define advanced care planning. It is
nothing but taking decisions for your own health. The decisions solely depend upon you. This is
about taking decisions about the type of care one wants to receive if he or she is unable to speak
(Mullick, Martin & Sallnow, 2013). We can take an example such as, if one is met with an
accident, after which he or she is unable to speak, one can tell the health care providers or the
caregivers regarding their wishes (Lovell & Yates, 2014). Advanced care planning mainly
includes:
 Obtaining information about the treatments that are life sustaining.
 Deciding what kind of a treatment one would opt for.
 Sharing the personal values with the loved ones.
 If one is unable to speak then completing the directives into writing and what type of
interventions or treatments, one would like to choose.
 Decisions about the end of life care for the patients, who are terminally ill.
Implications of the advanced care planning on health
Advanced care planning can involve discussions regarding the end of life and provision of the
early palliative care. Reaserches have suggested that Lack of end of life discussions and receipt
of aggressive care at the time of end of life deteriorates the conditions of patients and do not help
them to have a peaceful death (Bischoff et al., 2013). On the other hand the advanced care

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planning had been able to bring about better outcomes in the terminally ill patients, specially the
patients suffering from diseases like cancer and neurodegenerative diseases (Houben et al.,
2014).
Communication about advanced care planning or end of life can be tough job for the family
members or the loved ones but it should be kept in mind that, lack of understanding of the wishes
of a person may result in devaluation of the person, loss in dignity of the person which can cause
additional distress in the family members (Brinkman et al., 2014)
Case study
Today I would like to throw some light upon the case of Mr. Joseph. He as 85 years old and was
suffering from acute dementia. He was facing with many troubles such as acute memory loss,
cognitive impairment, inability to do even the simplest tasks. He supposedly had developed
symptoms of kleptomaniac. All these reasons have led his withdrawal from the society.
Currently his condition had deteriorated as he had stopped taking food and medications and he
was under artificial life care support system. His daughter had reported, that the nurse that was
taking care of Mr. Joseph had applied restraints on him and had tried to feed him forcibly, it was
since then that Mr. Jospeh’s condition has deteriorated. Recently after consultation with the
doctors Mr. Joseph and his daughter have wished for an end of the artificial life care support
system.
Discussion question
Was the decision taken up by the doctors and Mr. Joseph’s daughter, right?

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It can be stated as a right decision as the decision would help Mr. Joseph to die peacefully. He
thinks that he had already accomplished his goals in life and now he wants a peaceful death. It
should be noted that such a decision would be useful in bringing about a dignified and peaceful
death in the person.
Conclusion
Advanced care planning or end of life decisions can be painful for the patients and the family
members and the doctors, but lack of perceptive of a person’s desires can bring distress in the
patient’s health. It can pose additional distress to the health care professionals. Hence advance
care planning is important to reduce the distress and serve the dignity of the patient.

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References
Bischoff, K. E., Sudore, R., Miao, Y., Boscardin, W. J., & Smith, A. K. (2013). Advance care
planning and the quality of end‐of‐life care in older adults. Journal of the American
Geriatrics Society, 61(2), 209-214.
Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance
care planning on end-of-life care: a systematic review. Palliative medicine, 28(8), 1000-
1025.
Houben, C. H., Spruit, M. A., Groenen, M. T., Wouters, E. F., & Janssen, D. J. (2014). Efficacy
of advance care planning: a systematic review and meta-analysis. Journal of the
American Medical Directors Association, 15(7), 477-489.
Lovell, A., & Yates, P. (2014). Advance care planning in palliative care: a systematic literature
review of the contextual factors influencing its uptake 2008–2012. Palliative
medicine, 28(8), 1026-1035.
McMahan, R. D., Knight, S. J., Fried, T. R., & Sudore, R. L. (2013). Advance care planning
beyond advance directives: perspectives from patients and surrogates. Journal of pain
and symptom management, 46(3), 355-365.
Mullick, A., Martin, J., & Sallnow, L. (2013). Advance care planning. Bmj, 347(7930), 28-32.
Robinson, L., Dickinson, C., Bamford, C., Clark, A., Hughes, J., & Exley, C. (2013). A
qualitative study: professionals’ experiences of advance care planning in dementia and
palliative care,‘a good idea in theory but…’. Palliative medicine, 27(5), 401-408.

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van der Steen, J. T., van Soest-Poortvliet, M. C., Hallie-Heierman, M., Onwuteaka-Philipsen, B.
D., Deliens, L., de Boer, M. E., ... & de Vet, H. C. (2014). Factors associated with
initiation of advance care planning in dementia: a systematic review. Journal of
Alzheimer's Disease, 40(3), 743-757.