We have developed a guide for planning for the last days of life in response to requests from patients and their families to have a cohesive guide covering choices for end of life care.
We find that there is no ideal point in a person’s illness to raise this, and this is very much dependent on the individual patient.
Raising the subject of advance care planning does involve considerable skill on behalf of the healthcare professional and is ideally done where a relationship of trust has been developed with the patient.
Often the process is done in a number of stages, and leaving a booklet in the house for the patient and family to look at in their own time may be appropriate. Patients and their families should not be pressurised into doing advance care planning, but equally, we believe that patients should be given an opportunity to plan for their future, thus retaining some degree of control over their lives.
We have also developed a document to facilitate decision-making for care of patients lacking capacity. The document aims to bring together relevant carers, family and healthcare professionals to share information which can help with making a ‘best interests’ decision.