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Advance care planning: what do patients want?
1Junior Clinical Fellow, Department of Elderly Medicine, Barnet Hospital, Royal Free London NHS Foundation Trust, Barnet EN5 3DJ.
Introduction:
Advance care planning is the process by which patients can make decisions about their future health care should they lose capacity. Such conversations are shown to improve quality of life and reduce institutionalization. This article explores the preferences and wishes of patients in terms of advance care planning.
Methods:
CINAHL, Medline, Embase and Pubmed were searched. Key words included 'elderly', 'advance care planning', 'advance directive', 'views' and 'opinions'.
Results:
A total of 64 abstracts were screened and 20 full text articles read; 11 articles were included in the final study. Individual and cultural differences influence the level of decision making that patients want. Most studies agreed that conversations should be carried out opportunistically by a trained health-care professional. Patients value honest and open conversations, without which they may make misinformed decisions.
Conclusions:
The level of shared decision making that individuals personally want should be established. Open and honest conversations should be initiated at the earliest opportunity.
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