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Questions and Answers
What is the main purpose of an Advance Directive?
What is the main purpose of an Advance Directive?
Which of the following is a key benefit of advance care planning for hospital patients?
Which of the following is a key benefit of advance care planning for hospital patients?
What is a key challenge in implementing effective advance care planning?
What is a key challenge in implementing effective advance care planning?
What is the primary goal of an anticipatory care plan in the context of advance care planning?
What is the primary goal of an anticipatory care plan in the context of advance care planning?
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What is a key benefit of advance care planning for patients with terminal cancer?
What is a key benefit of advance care planning for patients with terminal cancer?
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What is a key benefit of motivating general practitioners to engage in advance care planning discussions?
What is a key benefit of motivating general practitioners to engage in advance care planning discussions?
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What is the primary goal of Advance Care Planning (ACP)?
What is the primary goal of Advance Care Planning (ACP)?
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Which of the following is a key feature of Advance Care Planning?
Which of the following is a key feature of Advance Care Planning?
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What distinguishes Anticipatory Care Planning from Advance Care Planning?
What distinguishes Anticipatory Care Planning from Advance Care Planning?
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What role does the interdisciplinary team play in Advance Care Planning?
What role does the interdisciplinary team play in Advance Care Planning?
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What is a common misconception associated with Advance Care Planning?
What is a common misconception associated with Advance Care Planning?
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Why is facilitating choice an essential component of Advance Care Planning?
Why is facilitating choice an essential component of Advance Care Planning?
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What percentage of community patients identified for palliative care due to dementia or frailty were referred to specialist palliative care?
What percentage of community patients identified for palliative care due to dementia or frailty were referred to specialist palliative care?
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In Scotland in 2016, what was the second most common place of death for all causes?
In Scotland in 2016, what was the second most common place of death for all causes?
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What has the potential to help address major challenges facing palliative care according to the text?
What has the potential to help address major challenges facing palliative care according to the text?
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Which article discusses residents' and relatives' views on advance care planning, end-of-life care, and decision-making in nursing homes?
Which article discusses residents' and relatives' views on advance care planning, end-of-life care, and decision-making in nursing homes?
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Which professional group is NOT typically involved in interdisciplinary team care for palliative patients?
Which professional group is NOT typically involved in interdisciplinary team care for palliative patients?
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What has been identified as an idea that has the potential to help work with patients and their families according to the text?
What has been identified as an idea that has the potential to help work with patients and their families according to the text?
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Advance Care Planning is primarily focused on educating patients and families about end-of-life care options.
Advance Care Planning is primarily focused on educating patients and families about end-of-life care options.
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Advance Care Planning is more effective at improving quality of life for patients with terminal cancer compared to patients with organ failure or dementia.
Advance Care Planning is more effective at improving quality of life for patients with terminal cancer compared to patients with organ failure or dementia.
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The main purpose of an Advance Directive is to facilitate choice and control for patients over their future healthcare decisions.
The main purpose of an Advance Directive is to facilitate choice and control for patients over their future healthcare decisions.
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One of the key challenges in implementing effective Advance Care Planning is overcoming patient and family members' misconceptions about the process.
One of the key challenges in implementing effective Advance Care Planning is overcoming patient and family members' misconceptions about the process.
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Anticipatory Care Planning focuses on discussing and planning for future healthcare decisions, while Advance Care Planning is primarily concerned with end-of-life care preferences.
Anticipatory Care Planning focuses on discussing and planning for future healthcare decisions, while Advance Care Planning is primarily concerned with end-of-life care preferences.
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Interdisciplinary team care for palliative patients typically involves nurses, social workers, and chaplains, but not general practitioners.
Interdisciplinary team care for palliative patients typically involves nurses, social workers, and chaplains, but not general practitioners.
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In Advance Care Planning (ACP), patients can appoint a trusted individual to make healthcare decisions on their behalf if they become incapacitated.
In Advance Care Planning (ACP), patients can appoint a trusted individual to make healthcare decisions on their behalf if they become incapacitated.
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Advance Care Planning (ACP) should be initiated only when a patient is diagnosed with a terminal illness.
Advance Care Planning (ACP) should be initiated only when a patient is diagnosed with a terminal illness.
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Research has shown that Advance Care Planning (ACP) can result in higher rates of aggressive interventions for patients with terminal cancer.
Research has shown that Advance Care Planning (ACP) can result in higher rates of aggressive interventions for patients with terminal cancer.
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An Anticipatory Care Plan is a legal document that allows patients to outline their healthcare wishes in writing.
An Anticipatory Care Plan is a legal document that allows patients to outline their healthcare wishes in writing.
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Engaging general practitioners in Advance Care Planning (ACP) discussions can lead to better representation of non-cancer patients and earlier access to palliative care.
Engaging general practitioners in Advance Care Planning (ACP) discussions can lead to better representation of non-cancer patients and earlier access to palliative care.
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Advance Care Planning (ACP) has been shown to increase depression and anxiety levels in patients with terminal illnesses.
Advance Care Planning (ACP) has been shown to increase depression and anxiety levels in patients with terminal illnesses.
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Advance Care Planning (ACP) is solely focused on end-of-life decisions and does not involve ongoing discussions.
Advance Care Planning (ACP) is solely focused on end-of-life decisions and does not involve ongoing discussions.
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Anticipatory Care Planning is primarily used for patients with long-term conditions to plan for expected changes in their health or social status.
Anticipatory Care Planning is primarily used for patients with long-term conditions to plan for expected changes in their health or social status.
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The goal of Advance Care Planning is to facilitate discussions and document personal wishes, including preferred place of care in the last days of life, even when the patient no longer has decision-making capacity.
The goal of Advance Care Planning is to facilitate discussions and document personal wishes, including preferred place of care in the last days of life, even when the patient no longer has decision-making capacity.
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Educating patients and families about Advance Care Planning is unnecessary, as the clinicians and wider team can make decisions without involving them.
Educating patients and families about Advance Care Planning is unnecessary, as the clinicians and wider team can make decisions without involving them.
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$\frac{1}{3}$ of patients with terminal cancer who engage in Advance Care Planning discussions are more likely to receive aggressive, life-prolonging care contrary to their wishes.
$\frac{1}{3}$ of patients with terminal cancer who engage in Advance Care Planning discussions are more likely to receive aggressive, life-prolonging care contrary to their wishes.
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Advance Care Planning discussions should be avoided for patients with dementia or frailty, as they may lack decision-making capacity.
Advance Care Planning discussions should be avoided for patients with dementia or frailty, as they may lack decision-making capacity.
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What is the main focus of the Burden model when conceptualizing support needs of family carers?
What is the main focus of the Burden model when conceptualizing support needs of family carers?
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According to the Stress and coping model, what is the primary focus when assessing family carers' support needs?
According to the Stress and coping model, what is the primary focus when assessing family carers' support needs?
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In the context of conceptualizing family carers' needs, which model focuses on caregiving within social relationships?
In the context of conceptualizing family carers' needs, which model focuses on caregiving within social relationships?
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What does the Stress and coping model primarily measure when assessing family carers' support needs?
What does the Stress and coping model primarily measure when assessing family carers' support needs?
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When examining support needs of family carers, which model focuses on promoting coping mechanisms and 'fixing' problems?
When examining support needs of family carers, which model focuses on promoting coping mechanisms and 'fixing' problems?
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Which theoretical position emphasizes that family carers should be viewed within the realm of social relationships?
Which theoretical position emphasizes that family carers should be viewed within the realm of social relationships?
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Which of the following is a recommendation for supporting family carers?
Which of the following is a recommendation for supporting family carers?
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Which group of family carers is highlighted as having special needs that require consideration?
Which group of family carers is highlighted as having special needs that require consideration?
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What should be embedded in practice to support family carers?
What should be embedded in practice to support family carers?
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Which group is identified in the text as also experiencing problems during palliative care and having needs that must be addressed?
Which group is identified in the text as also experiencing problems during palliative care and having needs that must be addressed?
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What is a recommendation for improving transitions between care settings for patients and family carers?
What is a recommendation for improving transitions between care settings for patients and family carers?
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What role do volunteers potentially have in supporting family carers?
What role do volunteers potentially have in supporting family carers?
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Which of the following is NOT considered a supportive activity for family carers according to the text?
Which of the following is NOT considered a supportive activity for family carers according to the text?
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Which of the following interventions is NOT typically available to support family carers?
Which of the following interventions is NOT typically available to support family carers?
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Which of the following is a key characteristic of interventions to support family carers, as described in the text?
Which of the following is a key characteristic of interventions to support family carers, as described in the text?
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What is a key challenge in providing effective support for family carers?
What is a key challenge in providing effective support for family carers?
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What is a key focus of the 'Preparedness for caregiving intervention' mentioned in the text?
What is a key focus of the 'Preparedness for caregiving intervention' mentioned in the text?
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Which of the following is NOT identified in the text as a type of therapeutic activity available to support family carers?
Which of the following is NOT identified in the text as a type of therapeutic activity available to support family carers?
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Study Notes
Advance Care Planning (ACP)
- ACP is an approach to facilitate discussion and documentation of personal wishes, including preferred place of care, in the last days of life.
- It can be used to anticipate needs that may arise when the person concerned no longer has the capacity to make decisions about their own care.
- Features of ACP include:
- Ongoing discussion
- Involvement of patient, clinician/wider team, and family member(s)
- Explores context, including beliefs, understandings, hopes, and expectations
- Addresses patient-related information needs
- Usually covers care at the end of life
- Usually results in a document
- Founded on a good therapeutic relationship
Anticipatory Care Planning
- Described as adopting a 'thinking ahead' philosophy of care that allows practitioners and their teams to work with people and those close to them to set and achieve common goals.
- Commonly applied to support those living with a long-term condition to plan for an expected change in health or social status.
- It incorporates health improvement and staying well.
Advance Directives
- Legal documents that allow patients to put their healthcare wishes in writing, or to appoint someone they trust to make decisions for them, if they become incapacitated.
- Examples include:
- Advance Directive (or Decision) to Refuse Treatment (ADRT)
- Living Will
- Enduring Power of Attorney
Research on ACP
- ACP in elderly hospital patients can deliver:
- Greater likelihood of end of life care wishes being fulfilled
- Lower levels of stress and higher levels of satisfaction among family members
- ACP in out-patients with terminal cancer can result in:
- No increases in depression or anxiety
- Lower rates of aggressive interventions
- Earlier hospice referral
- Better bereavement experiences for family members
- A concerted approach among hospital patients can deliver:
- Substantial uptake of ACP
- Motivating General Practitioners around ACP can result in:
- Substantial uptake of ACP
- Better representation of non-cancer patients
- Earlier access to palliation
Good Practice in ACP
- Start as early as possible, while the person is well enough and has sufficient capacity to fully engage.
- Good practice in ACP results in:
- Greater likelihood of end of life care wishes being fulfilled
- Lower levels of stress and higher levels of satisfaction among family members
Demographic Changes
- Increasing longevity, especially among people over 85 years
- Changing women's role in society, with increasing employment outside the home, later childbearing, and fewer children
- Changing marital relationship patterns, including single parenting and step parenting
Support Needs of Family Carers
- Can be conceptualized using three theoretical positions:
- Burden model
- Stress and coping model
- Social relationship model
- Evidence suggests that family carers have a range of support needs, including:
- Information and education
- Supportive activities
- Therapeutic activities
- Strategies for safe moving and handling of the patient
Interventions to Support Family Carers
- There is little robust evidence on which interventions are best
- A menu of options may be most effective
- Interventions should be timely, accessible, affordable, and appropriate
- Examples of interventions include:
- Information and education
- Supportive activities
- Therapeutic activities
- Strategies for safe moving and handling of the patient
- Access to welfare or benefits advice
- Complementary therapies
- Psychotherapy
Implications and Recommendations
- There may be a greater role for volunteers in supporting family carers
- Staff need training in understanding different cultures, norms, and expectations of families
- Consideration should be given to the special needs of family carers of those with dementia or more prolonged caregiving periods
- Regular assessment of family carers' needs should be embedded in practice
- Improve transitions between care settings to reduce disruption and distress for patients and family carers
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Description
Explore the concept of Advance Care Planning (ACP) which involves discussing and documenting personal wishes for end-of-life care. Learn about the definitions, benefits, and key components of ACP, including anticipatory care planning and advance directives.
