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Joy

Joy Cocker

Year of Award: 2014 Award State: Australian Capital Territory Health And Medicine > Aged Care
Health And Medicine > General
The Dr Dorothea Sandars and Irene Lee Churchill Fellowship to explore Advance Care Planning programs which respect and honour people's wishes for health care including at the end of life care - Canada, USA

It has only been in the last 20 years or so that what is known as ‘advance care planning’ (ACP) has been conceptualised and programs systematically developed and implemented in health care settings. This development has been as a response to the increasing advances in medical technology and the corresponding complexity and choices people have to make in every sphere of their lives including health care. Coupled with this phenomena is the fact that people are living longer and, as the research informs us, are more likely towards the end of their lives to have repeated hospital admissions and to spend their last days in an acute hospital ward.

Advance care planning is recognised as a process that begins with ‘having the conversation’ about wishes and choices around health care for a time when/if you are unable to speak for yourself including at the end of life. Conversations about death and dying and the health care we would want including at the end of life is a very personal process that can happen anywhere including around the ‘kitchen table’ with those who are close to us like our family and friends. These same conversations happen with healthcare professionals in a health setting. However these conversations are not always easy either between people or between the heath care professional and the patient and family.

I undertook this Fellowship to explore advance care planning programs in Canada and the USA. My brief was broad to reflect the work that is undertaken by the Respecting Patient Choices program in the ACT. This exploration included: Community marketing and promotion campaigns, proven processes for engaging with and facilitating ACP; systems of ACP in the hospital that may prevent unwanted treatments and hospital admissions; quality measures that assess the impact of ACP on people’s experiences at the end of life and ACP facilitator training. It was my intention to bring back the findings, to share the information and knowledge with colleagues for the enhancement of advance care planning in the ACT and more broadly Australia.

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