Introduction
Advance care is an important facet of healthcare, one that allows individuals to be better prepared for the unexpected outcomes of life. As a term, it refers to a series of practices and activities directed at answering the need to promote patient choice and agency in cases where their ability to speak for themselves may be impaired. If an individual can expect that their health problems are severe or lifelong, planning ahead is the most optimal solution a person can come to. Therefore, it is important to inform the public about proper measures in advance healthcare planning, working together with medical professionals in giving individuals a more comprehensive understanding of their health and their rights. For the purposes of this work, the subject of healthcare planning will be examined, and I will discuss my own experiences with the process. Using existing materials on the subject, workbooks, and other types of information, I have attempted to make informed choices about my life
Care Planning
According to the five-step plan toward achieving proper advance care planning, the first step is to think about one’s beliefs, values and wishes regarding healthcare. For me as an individual, it is important to maintain my wellness in the long term, and ensure I am able to life happily, support my family, and contribute to the community. There are some specific health problems that have accompanied me through life, including back pains and various heart conditions. Having to participate in the medical system from a young age, I have decided that I want to think thoroughly about the types of care I want to receive. In addition, I have also thought about growing old, and possibly requiring care from a social worker. My family has a relatively high risk of dementia, which is a scary possibility for me. If I were to be affected by the condition, my ability to advocate for my own health would diminish considerably. Most likely, it would render me completely unable to consider the types of care I need and the best practices to guarantee health. Because of that, I need to plan ahead and find a way to secure a capable social worker, as well as inform one of my close relations about the need to speak on my behalf. I want to be heard, and I want to be respected as an individual, even in future cases where it may be difficult to persuade me. This conviction is something I want to transfer to the person who will be my trusted individual.
Learn
According to existing data, advance care planning has the capacity to increase the quality of life and outcomes for people. In a 2018 study, it was found that advance care planning is beneficial to patients, although accompanied by feelings of discomfort (Zwakman et al., 2018). Confronting one’s loss of agency, illness, and potential mortality is difficult, which is why people must be supported in the process of advance care planning. Reading the study made me more confident in working for my future, and gave me an evidence-based look onto the influence care planning has on health. After investigating the data from this study, I went ahead in examining existing information regarding dementia and advance care planning. The resource provided by the Social Care Institute for Excellence was especially notable in this process (“Advance care planning in dementia,” 2020). It highlighted many of the problems dementia patients face in their life, as well as emphasized the need for advance planning. If I do not make informed decisions about my future, I may not have another opportunity to do so when it is truly needed. In addition, the resource also suggested writing a will, choose treatment options that are deemed acceptable, and legally underpin a designation of another person as being responsible for my wishes.
Decide
After doing due research, I have proceeded to the task of choosing a person who may represent my needs in the case of crisis. I considered my friends, loved ones, friends and other people I know, thinking about their personal qualities, their perception of myself, and the likelihood of them prioritizing my own wishes. In the end, I decided to name my best friend as the trusted individual who would be able to direct care, as they fulfill the criteria I chose. Firstly, they are the same age as me, meaning that they will likely be able to live long enough to advocate for me, and still retain their own clarity of mind. At the same time, my best friend has also spent considerable time with me, and respects my needs and wishes. I feel that they will be able to recognize my need for autonomy and good healthcare, and advocate for it.
Talk
After making my final decision, I have gone ahead in breaking the news to my friend, and having an open conversation about the subject. Beforehand, I made sure to look up appropriate resources about how an advanced care conversation should proceed (“Starting the conversation,” n.d.). I chose a quiet environment to discuss the subject in, and ensured that we would not be interrupted in the process. I could not come up with a specific plan or script for this conversation, although I was confident we would be able to navigate it given time and patience. I started talking about my dreams and wishes, my family, my career, everything that I deemed to be important at this moment. Explaining how the life that I am leading is a result of many choices, many of which I am proud of, I wanted to make sure that my fondness for my current way of life is palpable. Then, I transitioned into discussing news cases and other stories we heard about, regarding people who lost everything in tragic accidents. I mentioned individuals that became bedridden overnight, those that were taken by illness, or slowly deteriorated to their present condition. Those examples helped to set the tone for the conversation and narrow down the focus, by which point my friend was beginning to understand what I am talking about. We discussed how the same things that happened to these people may happen to us one day, and that there is a certain need to prepare for that possibility. After which, I listened to my friend talk about their own chronic illnesses, and their deep-seated worries regarding health.
I think we were able to reach a certain level of understanding then, capable of taking the idea of advance healthcare planning seriously. When we reached a mental and ideological agreement, I started talking about the history of dementia in my family, and other conditions that I may develop in late adulthood. I tried to emphasize a feeling of powerlessness and a lack of control that would come with dementia, and wishes explicitly to avoid it at all costs. Feeling that I competently explained why I was concerned, I asked my friend to advocate for me in the case I am no longer able to. I mentioned that they were the only person I could rely on in case of a health emergency, and I want them to understand my perspective on life. In conclusion, I also covered some of the common if-then scenarios, regarding healthcare, such as hospice care, life support and others. My friend has promised to remember the conversation and take my wishes seriously, as well as accepting the role of a trusted health advocacy expert.
Record
In order to ensure that my own wishes are met, and that there are no potential ways to misinterpret, distort, or alter my wishes for care, I wrote them down in a digital format. The copy of my healthcare wishes is stored on the cloud, on a flash drive, and on my personal computer. I felt that making copies would ensure its safety, and ease of finding the necessary information. In the document itself, I have outlined my desire for a social worker, emphasized problems dementia patients face, and explained my wishes for the future clearly. Furthermore, I included all of the information regarding my financial information, addresses, phone numbers, card details, and other types of data (“Getting your affairs in order,” n.d.). I clarified my stance on hospice care and other forms of long-term treatment, making sure to put in caveats and explanations in order to make my points clear. Furthermore, I have also listed some of the health conditions I possess, in the potentiality that I may not be able to talk about them personally.
Reflection
As a whole, I think the initiative to facilitate advance healthcare planning was a success. Despite my hesitancy and reluctance to actively discuss matters of my health, agency and illness with others, I think the process taught me that it is important to talk about my own needs and desires more, as discussing them makes it easier to determine my priorities in life. Furthermore, the process helps in deciding on older life care, and disease treatment options in advance. If I do all of the necessary reading now, I will be less likely to be caught of guard when actually requiring medical assistance.
In addition, this process has opened up the possibility of future conversations on advance care planning in my family. Both of my parents are deeply spiritual, often telling me that talking about advance care is akin to inviting misfortune. By disassociating myself from these beliefs, I was able to protect what is important to me in the years to come and invite deeper introspection in others. My friend, in particular, is currently also researching advance healthcare planning solutions, deciding on what her own values are, and preparing. While I was not confident in the outcome of this exercise, I am content in having attempted it, and I think that more people should recognize the importance of thinking about the future.
Nursing and Care Planning
Nurses play a central role in promoting Advance Care Planning. As healthcare professionals, they possess the necessary insight, skill and outreach to inform their clients about the need to plan ahead. Because of their position as an intermediary of care, they can connect individuals to other professionals, refer them to necessary specialists, and provide materials on advance healthcare planning. I think that giving patients information about healthcare planning is one of the central roles a nurse should play, and a component of healthcare rarely discussed in professional settings. In order to insure that people are able to make decisions about their life, about their future, it is vital for nurses to contribute to the process of patient education (Miller et al., 2019). Furthermore, working in advance patient care can streamline the healthcare delivery process, giving more medical professionals the capacity to work with people who want to receive their assistance. In this way, the traffic of patients will be diverted to those who must answer it, and the wishes of the patients will be met.
Impact on my Nursing Practice
In addition to improving my own relationship with healthcare planning, and the future wellness of my family members, I think that the process has positively impacted my nursing practice as well. As a nurse, I have a responsibility to provide care to the patients. The process, however, includes far more than simply administering medicine or filling prescriptions. Nurses are leading figures in interacting with the clients, those that first come into contact with the patient’s needs, and those that are more acutely aware of their troubles. Furthermore, nurses are professionally obligated to do extensive research, adhere to evidence-based practice, and work toward improving their skills in their areas of expertise.
Doing research on advance care planning has given me a new framework to interpret the experiences of patients, and understand the need to help them navigating medical care. With this experience, I will be able to initiate difficult conversations about long-term care, end-of-life planning and other considerations that may come from advance healthcare planning. In addition, having experienced the process of navigating a conversation about health, I may be able to better advice patients in initiating their own dialogues. This includes instructing patients on how to inform their loved ones, how to write down their wishes, and what learning resources to consider for further education.
Conclusion
In conclusion, it can be said that advanced healthcare planning is an important facet of healthcare, one capable of protecting individuals in cases where they are no longer able to speak for themselves. Personally, I have attempted to follow the existing guidelines and manuals for advanced health practice, giving me the required knowledge base to adhere to the process and make informed choices about my future. By engaging with advanced healthcare planning, I have ensured that I will be able to lead a more happy, fulfilled, and healthy life in my older years. Additionally, the process has significantly empowered my nursing practice, allowing me to become a better specialist for my field. By gaining personal experience and studying existing materials, I gained an ability to help patients make informed decisions about their lives. As a whole, the nursing body should strive to more thoroughly incorporate concepts of advance care planning in their work. This process would help in streamlining healthcare delivery services, and enhance the quality of patient care for many.
References
Advance care planning in dementia. (2020). Social Care Institute for Excellence (SCIE). Web.
Getting your affairs in order. (n.d.). National Institute on Aging. Web.
Miller, H., Tan, J., Clayton, J. M., Meller, A., Hermiz, O., Zwar, N., & Rhee, J. (2019). Patient experiences of nurse-facilitated advance care planning in a general practice setting: A qualitative study. BMC Palliative Care, 18(1). Web.
Starting the conversation. (n.d.). Advance Care Planning Australia. Web.
Zwakman, M., Jabbarian, L., Van Delden, J., Van der Heide, A., Korfage, I., Pollock, K., Rietjens, J., Seymour, J., & Kars, M. (2018). Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness. Palliative Medicine, 32(8), 1305-1321. Web.
