[Advance Care Planning is not a pipe dream!]

The retrospective observational study by Assimakis et al. on Advance Care Planning (ACP) implemented in primary (or general) home palliative care found that 62% of medical records closed due to completion of the care pathway contained a ACP in which the patient's wishes were documented in 83.9% of cases and that of the family members in 90.3%. The PCC was formulated by the General Practitioner (GP) with the patient in all cases except in cases of dementia or delirium, in which it was carried out with a family member previously appointed as a proxy by the patient. In 61% of cases, the community care nurse (district nurse) also contributed to the PCC. Advance will concerned possible hospitalization (90.3%), while indications on treatments (45.2%) and palliative sedation (16.1%) were less frequently documented. The study demonstrates that PCC can be implemented in daily care practices, even in general practice and in the community care, provided there is sufficient awareness and training on the topic. The latter are greatly facilitated by the presence of the Local Palliative Care Network.