Advance care planning (ACP) is a critical component in end-of-life care. By proactively considering how, when, and where they prefer to receive medical treatment, hospice patients can both streamline care processes and significantly reduce the stress of familial decision-making in the event they can’t speak for themselves.
According to the CDC, however, 70 percent of Americans don’t have an advance care plan.1 This is especially problematic for hospice providers tasked with providing end-of-life care for patients — while Hospice News notes that advanced care plans can significantly improve patient quality of life, the lack of any detailed plan means patients and their families may not get the full benefits of hospice care.2
Pandemic pressures also contribute to this care conundrum. Although hospices have seen an increase in the total number of patients seeking care, the disproportionate impact of COVID-19 on elderly Americans means that many arrive with more severe symptoms and spend less time in hospice before being transferred to the hospital.3
The result? In-depth advanced care planning is critical in the effort to both improve patient experience — and enhance hospice care success. Here’s how.
Improve Patient-Provider Communication
In a recent ACP paper, Advance Care Planning and Advance Directives, author Maria J Silveira makes it clear that when it comes to questions around preferred patient treatment plans, the answers depend “upon the patient and their own goals, values and preferences, and cannot be accurately predicted by the clinician or the family.”4 For hospice care providers, therefore, discussions around advanced care plans — whether this takes the form of reviewing current ACPs or drafting new plans in tandem with patients and their families — offers a way to improve communication and enhance the overall hospice experience.
As noted by Cancer.org, the goal of hospice care is to treat both the person and the symptoms of their disease simultaneously; in-depth and up-front discussions of ACP requirements help ensure that patients feel heard, valued and respected.
Streamline Care Practices
In the context of current COVID conditions, advance care planning is more critical than ever. As noted in The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During Novel Coronavirus 2019 (COVID-19), “advance care planning prior to serious acute illness and discussions about goals of care at the onset of serious acute illness should be a high priority.”5
For hospice providers, the codification of discussions into actionable treatment plans, such as specific conditions for Do-Not-Resuscitate (DNR) orders, helps streamline care practices by providing a clear roadmap for providers. Advanced hospice software solutions, meanwhile, ensure that advanced care plans are always available for review by both patients and caregivers.
Reduce Operational Complexity
Just over half of Americans have had conversations with loved ones about their end-of-life needs, and less than 20 percent had these conversations with hospice providers.6 This lack of communication creates potential complexity if patient symptoms suddenly worsen and they can’t effectively communicate; while family members may have some idea what patients want, providers are often left in the dark.
The result is substantively increased complexity as caregivers look to balance their expert assessment of patient needs with familial requests and potential conflicts. By making ACP discussions part of initial patient intake — whether this is review of existing ACP documents or the creation of a brand-new plan — hospice companies can sidestep operational complexity and focus on what matters most: improving end-of-life care.
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1 CDC, “Give Peace of Mind Advance Care Planning,” April 30, 2018.
2-3 Hospice News, “Vantage: Advance Care Planning Promotes Hospice Growth,” February 16, 2021.
4 Silveria, Maria J., “Advance Care Planning and Advance Directives,” March 31, 2020.
5 Curtis, Randall J., “The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During Novel Coronavirus 2019 (COVID-19),” March 27, 2020.
6 Hamel, Liz, “Views and Experiences with End-of-Life Medical Care in the U.S.” April 27, 2017.