The following might be discussed as part of an advance care planning discussion:
Statement of wishes and preferences for future care
This is a record of what is important to your loved one and how best to meet their care needs on a day-to-day basis. This may include psychological support (wellbeing), social support (visiting) and spiritual support (their beliefs).
It is important to discuss these topics during COVID-19, because restrictions may affect how your loved one’s needs can be met. It is also necessary to have this information recorded in case your loved one contracts COVID-19. You may wish to discuss COVID-19 vaccinations.
Watch the video below to hear Professor Nancy Preston talk about advance care planning during COVID-19.
Emergency care plan
An emergency care plan is particularly important for your loved one during COVID-19 and gives recommendations on the care and the realistic treatments they would like to receive in an emergency situation, and the treatments they would not like to receive. For example, whether they wish to stay in the care home or be admitted to hospital.
It is likely that you will discuss what should happen in the event that your loved one’s heart stops, and they stop breathing. You may decide together whether a Do Not Attempt Cardio pulmonary Resuscitation (DNACPR) recommendation is appropriate either because CPR would not work or because it might work but would not be wanted.
A clinician, such as a GP or nurse, is usually involved in producing the emergency care plan.
Best interest decision making
Best interest decision making is when a choice about care is made on behalf of a person who is not able to decide for themselves because they are assessed as lacking mental capacity. This decision must be taken with the person’s best interests in mind, and be informed by what the person would want.
Sometimes a medical decision needs to be made. This is when a member of health or care staff is required to urgently deliver care to your loved one who is unable to inform professionals of their preferences at that time. Staff will act in your loved one’s best interests in that moment, informed by their own expertise and professional judgement. This may sometimes be different to what you and your loved one have previously discussed, for example, if their health has rapidly changed in the meantime and a recorded preference is no longer clinically appropriate.
Specialist care needs
Specialist care needs might be discussed within the context of COVID-19, for example, if your loved one has a long-term condition or a diagnosis of dementia. Your loved one may have several conditions so decisions will need to take account of these in the best possible way.
Watch the video below to hear Dr Karen Harrison Dening talk about advance care planning and dementia.
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