Benefits and Preparation of Advanced Care Planning for Palliative Care Patients

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

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Introduction
Advanced care planning can be referred to as the formal decision making that is for
helping the patients establish decisions about the future care that comes in to effect when they
lose the capacity (Lovell & Yates, 2014).
The assignment is based on the Melissa, a 37 years old women, who had been suffering
from stage 4 Bowel cancer and requires advanced care planning. The assignment aims to focus
on the benefits of the advanced care planning process Melissa, the possible preparation needed
before the initiation of the advanced care planning process including the choice of the members
for the discussion process, the multidisciplinary teams , the mental or the physical status of the
patient to be able to participate in the decision making process. This assignment will also
discuss about the type of information that should be included in the advance care planning and
when and how the advance care will be reviewed.
Possible benefits of the advance care planning for Melissa
Advanced care planning is important for people who are too old and frail or are suffering
from terminal disease such as cancer, where apart from the treatment the wishes of the patient
are documented or the ill person in encouraged to choose a substitute decision maker to know the
health care preferences of the ill person (Lovell & Yates, 2014). In an ACP the patients, families
and the health professionals discuss and establish the future goals of care according to the
preferences of the patient (Lum, Sudore & Bekelman, 2015). It is evident form the case study

2PALLIATIVE CARE
that Melissa had been suffering from stage 4 Bowel cancer. A stage 4 cancer means that the
disease have spread from th colon to the distant organs. Melissa might already be going
through several physical and emotional burden. The burden of cancer, medications and the
chemotherapy is very painful and causes several side effects that decreases the quality of life.
Furthermore the sense of having very few days of life can bring about depression in the patient
(Houben et al., 2014).
The advanced care planning includes getting information about the different types of life
sustaining treatments that are normally available, deciding on the type of treatments that is
anticipated, sharing the personal values with the loved ones (Bischoff et al., 2013). It is evident
that Melissa has two children, hence Melissa might wish to consult a lawyer to discuss about the
will, or whether her children should be given in charge of her ex-husband since, and there had
been a shared caring towards the children. Furthermore, Melissa might also want her husband to
be contacted, since they had been separated for long 10 years and she might want to discuss
about how their children should be taken care off. Melissa might also need some time to wrap up
her work as she had been working as a full time administration assistant in a publishing company
and had been managing the important sector of the company. Furthermore, cancer is a chronic
complication that brings along several comorbidities that needs to be addressed by the help of a
multidisciplinary care team. Inadequate ACP might affect people’s life and their experiences
with the health care. At the end of life, most of the people prefer for treatment that are less
effective and focusses on the quality of life. According to Brinkman-Stoppelenburg, Rietjens &
van der Heide, (2014), the family members of the patient who have received an intensified
treatment at the end of life experience more guilt, depression and the reduced quality of life.
Initiation of conversation about the decision of care is necessary in front of the whole family,

3PALLIATIVE CARE
hence at first Melissa should be provided support to become mentally strong to take part in the
decision making process. Such conversations should not be done when the patient is too
emotionally weak or is going through heavy pain.
Time for the planning
Before an advanced care planning the clinicians might decide whether Melissa is eligible
for the advance care planning initiatives. Advanced care planning for a patient is initiated when
the patient is well enough to participate any kind of discussions, hence it is necessary that
Melissa is in an awakened state and have that functional capability to take part in the discussion
process. There are some studies that have discussed about some particular triggers for initiating
conversation, such as the recurrence of cancer. Since sudden changes might occur in the course
of the diseases, the opportunity to take part in the advanced care planning could be omitted if the
subject is not broached early (Billings & Bernacki, 2014). There are literary evidences that
claims that advance care planning might not be done to early as the course of the disease might
change or such planning might bring about additional distress of him which might deteriorate her
physical and mental health before the expected time (Greer et al., 2013).
Preparation prior to the discussion
The responsibility of engaging the patients in the advance care planning do not lie solely
on the physician. The multidisciplinary team are expected to work together in a coordinated
fashion for engaging the patent and the families. They should work in a coordinated fashion for
engaging the families and the patients (Chiarchiaro, Buddadhumaruk, Arnold & White 2015).
Before the initiation of the advance care planning it is necessary to assess the readiness of the
patient to discuss the advanced care planning. For this it is necessary to engage in frank and the