The relentless bleeping of hospital monitors, being prodded and poked by needles, loaded up with fluids and antibiotics.
Does that sound like something you would want for yourself? The choice is yours. It is not uncommon to see co-morbid patients, with poor reserves, admitted several times within the space of one month.
What these patients and their families don’t realize is that all of this can be avoided, should they so choose.
When it comes to our health, we often don’t realize the extent of our autonomy. Advanced care planning (ACP) is a powerful, underutilized, tool that enables and empowers patients to take the lead in their health journey.
ACP involves planning for your future healthcare and support, and all of this can be initiated by a simple conversation with your healthcare provider.
In 2016, ‘unnecessary admissions’ of the terminally ill cost the NHS approximately £2.5 billion a year. The aging population of the UK means that this figure is only likely to increase further.
ACP allows patients to think ahead and plan for instances where patients may require healthcare intervention.
It involves a discussion around which elements of care are important to an individual or which aspects of their care they feel strongly about. It mobilizes individuals to make decisions surrounding their healthcare while they can do so.
This prevents needless hospital admissions, which can be burdensome on the NHS but equally traumatic for patients who are unwell. Prolonged hospital stays for any individual pose a risk of infection and further deterioration; however, this effect is markedly greater for the frail and elderly.
Imagine going into a cardiac arrest. A team of doctors surrounds you, immediately starting chest compressions. A few ribs break and blood enters your lungs. During intubation, you break a few teeth and your lungs collapse.
All of this ‘collateral damage’ is a consequence of the mission to resuscitate you. An outcome that is neither guaranteed nor is it necessarily what you signed up for, but rather what was deemed to be best for you.
Perhaps you would have prioritized a good quality of life, but you can’t turn back to make that choice. It’s too late.
This is exactly why it is absolutely imperative that we initiate discussions about our ACP at an early stage.
Engagement in such conversations permits patients to make informed decisions, aligning with both their values and preferences. A proactive approach such as this helps to cultivate a collaborative relationship with healthcare providers that is patient-centered and not clinician-led.