It’s estimated that only 14 percent of Australians have an Advance Care Plan (ACP) that documents decisions about their future healthcare. However, a new initiative by Eastern Melbourne PHN (EMPHN) aims to make it easier for older people to have a greater say about how they are cared for in the future.
EMPHN has commissioned mecwacare and Carrington Health to increase the number of people in Melbourne’s east who have ACPs.
EMPHN CEO, Robin Whyte, said ACPs allow older people autonomy and dignity in the way they are cared for and to develop a plan consistent with their goals, values, beliefs and preferences.
“By creating a plan with their GP, older people can decide how they would like to be cared for before they become too unwell to make decisions for themselves,” she said.
“We want the number of people with ACPs in our community to increase so that patients’ decisions remain at the centre of their care as they age.”
mecwacare and Carrington Health will identify and provide opportunities for their clients to develop ACPs and contact GPs to finalise the plans.
An ACP will vary from person to person, depending on the person’s preferences and the type of care they would like to receive.
A plan usually includes names and contact details of people nominated to speak with doctors and health professionals on the person’s behalf, the care outcomes and treatments that would be acceptable to the person in accordance with their values, beliefs and preferences, and the person’s wishes for end of life care.
ACPs can be linked to My Health Record, an electronic health record containing information that people can choose to share with health practitioners.
When Mary, a long-term mecwacare client, received a flyer publicising an information session mecwacare was holding on Advance Care Planning, she was interested to hear more. At 86 years old, Mary felt she managed quite well at home with some support services. Maintaining her independence and ability to make her own decisions was very important to her.
A mecwacare staff member visited Mary at home and assisted Mary to develop her Advance Care Plan with her daughter Arlene’s involvement. Mary was given a copy of her plan to discuss with her doctor. Mary said she appreciated the opportunity to talk about and document all the things that she valued. This included her wishes in relation to medical treatment and the things that were important to her in the event that she could no longer stay at home or if she was close to death.
Arlene said, “Initially I found it difficult listening to Mum talk about her future loss of independence or death but after a while I started to feel more relaxed because Mum was so calm. Looking back now I really appreciate having had the opportunity to ask Mum more about her wishes and preferences."
Twelve months after developing her Advance Care Plan, Mary’s health deteriorated rapidly and unexpectedly to the point that she was unable to remain at home. As Mary’s ability to communicate her wishes was limited, Arlene was able to use the information Mary had previously provided in her advance care plan to guide her decision when choosing a Residential Aged Care Facility, based on the things Mary had said were important.
"If it wasn’t for that conversation, I would never have known that particular things were so important to Mum, particularly when she did reach the stage where she could no longer express herself.”
(Names have been changed in the above case study to protect the privacy of individuals involved.)
Eastern Melbourne PHN increases the efficiency and effectiveness of medical services for people in the eastern and north-eastern areas of Melbourne, particularly those at risk of poor health outcomes, to improve coordination of care and ensure patients receive the right care in the right place at the right time. EMPHN works across an area of 3,956 km² comprising a population of more than 1.5 million people. www.emphn.org.au This initiative is supported by funding from the Australian Government under the PHN Program.