Reassessing advance care planning in the light of covid-19

Abstract

Focus on creating a shared narrative not recording choices

End-of-life care during COVID-19: opportunities and challenges for community nursing

“…However, the pandemic response also opens up new opportunities for developing nurse roles in community settings, streamlining care, learning from what has worked well and reformulating collaborative working in the future (Green, 2020). COVID-19 has heightened awareness of the potential benefits of advance care planning when conversations are timely and sensitive to the priorities and concerns of the patient and those important to them (Hopkins et al, 2020; Queen's Nursing Institute (QNI), 2020). However, nurses working in the community report feeling ill-prepared to lead end-of-life care planning conversations and frequently describe learning these skills through experience, including trial and error (Griffiths et al, 2015a;Hadley, 2020).…”

Understanding and addressing challenges for Advance Care Planning in the COVID-19 pandemic: An analysis of the UK CovPall survey data from specialist palliative care services

“…(43) This is a concern raised by the public and clinical communities. (43,48,49) Considerations for clinical practice and policy COVID-19 has provided an opportunity to re-think ACP in which the starting point to any discussion is always the values and priorities of patients themselves. Initially, these discussions are likely to be broad in nature, with their focus then narrowing in line with the more immediate concerns of individuals.…”

“…This is because ACP is a multi-component process, not a one-time event/document, not least because preferences and priorities may change. (6-8, 10, 12, 34, 43-46) Delivering all of the multiple components of ACP, and delivering them well, is important to ensure inclusive, holistic, and individualised care that focuses on what matters most to patients. (47) Whilst understandable in the pandemic context, emphasis on discrete components of ACP may jeopardise the individualised and holistic qualities essential for the delivery of high quality and comprehensive ACP, and runs the risk of making ACP a ‘tick box exercise focused on a predetermined list of preferences’.…”

The impact of the COVID-19 pandemic on people with neurological disorders: an urgent need to enhance the health care system’s preparedness

“…It is essential that good care planning be undertaken to ensure that patients can choose which treatments they will receive from the menu of those that are available and most appropriate, even during the pandemic. Proactive planning and advance treatment arrangements should be a standard component of care provided by neurologists and primary care physicians [38]. However, after over 2 years from the passage of the Italian Law 219/2017, the implementation of ACP is very limited [39].…”