Advance Care Planning (ACP)

About

Encourage your patients to plan for the unexpected
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Advance Care Planning helps individuals to consider and make decisions about their healthcare before they lose mental capacity. It is a planning tool that encourages individuals to take more responsibility and autonomy in their healthcare.
 

Malhotra et al. (2012) conducted a qualitative focus-group based study involving Singaporeans (≥50 years) to understand the key components of good-end-of-life care as perceived by middle-aged and older Singaporeans (≥50 years). Eight components of good end-of-life care were identified:

  1. Have physical comfort at the end of life,
  2. Avoid inappropriate prolongation of the dying process,
  3. maintain sensitivity toward religious and spiritual beliefs,
  4. Avoid burden on the family,
  5. Avoid expensive care,
  6. Be cared for by a trustworthy doctor,
  7. Maintain control over care decisions, and
  8. Achieve a sense of completion.

The strength of the physician-patient relationship helps you as your patient's General Practitioner to better gauge the patient's readiness and broach the topic accordingly (Wichmann et al., 2018). Additionally, General Practitioners can make use of the longitudinal relationship to dissect the Advance Care Planning discussion into multiple sessions (Sharp et al., 2018), resulting in more discussions being held (Aoki et al., 2017).

To help mitigate the time pressure in your clinic, here are a few questions that you may ask your patients to help kick start the idea of planning ahead (Mahon 2011):

  1. If you cannot, or choose not to participate in healthcare decisions, with whom should we speak with?
  2. If you cannot, or choose not to participate in decision making, what should we consider when making decisions about your care?
  3. If you cannot, or choose not to participate in finance decisions, have you appointed someone who can do that for you?

When your patient is ready to make his or her Advance Care Plan, you can help refer them to a an Advance Care Planning node in the community. You may find the nearest Advance Care Planning node to your practice here

 

 

Resource


     
Living Matters Workbook (to guide ACP discussions)
View & download
​ Living Matters ACP brochure (in  4 languages)
View & download

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 To learn more about ACP, including training details to become a Certified ACP Facilitator, or to request for ACP materials for your patients, visit  www.livingmatters.sg or contact AIC at gp@aic.sg or 6632 1199.

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