Abstract:

Talking to patients about dying is never easy, so anything that can improve this communication has to be a significant benefit. Recent national developments in the UK have highlighted the importance of choice for patients in both the place they die, and the interventions they would want to have. Such developments are aimed at improving quality of care and empowering patients and include the national NHS End of Life Care Programme (2009) and The Mental Capacity Act (2005). This article examines the evidence behind using Advance Care Planning (ACP) as well as the practical issues of who might be best placed to undertake these discussions and what documentation tools to use. It concludes that care should be individualised and full use made of established professional relationships. Communication needs to be to the highest standard as the risks of causing distress are significant. Full use of the breadth of the multi-disciplinary team can enable full discussion of wishes around spiritual, social as well as medical care.

Author: Alison Rich, Julian Abel