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Clinical Innovation & Audit: Poster Numbers 111 – 141 – Planning care: Poster No: 112
Advance care planning in dementia and severe and enduring mental illness
  1. Madeline Bass1 and
  2. Helen Jackson2
  1. 1St Nicholas Hospice Care, Bury St Edmunds, Suffolk, UK
  2. 2Wedgewood House, Bury St Edmunds, Suffolk, UK


Background Dementia diagnoses are set to increase rapidly in the UK and this means that services need to be aware of the ethical issues associated with end of life care. The National Council for Palliative Care in the UK has worked hard to increase the knowledge of specialist palliative care professionals around issues relating to end of life care for people with dementia and their families. However, the bulk of the work will fall to generalist staff. This project looked at educating staff in a local mental health unit in Suffolk, as well as the patients and family carers of those with dementia, about this. It also looked at patient documentation, how staff approach such conversations and related ethical issues.

Aim This project looked at educating mental health staff about advance care planning in a local mental health unit and extending this into all mental health services across the county. The project would also produce specific documentation to ensure sustainability in the future.

Methods Five subjects of education occurred on a weekly basis each for 30 min between July and December 2010: (1) what is advance care planning?, (2) use of SPIKES model in communication, (3) how to communicate ACP information to other healthcare professionals, (4) issues around DNAR in end of life care for people with dementia and (5) five important points to know when caring for someone with dementia. During the education sessions, staff were asked for their opinions about formats for documentation and guidelines.

Results By early 2011 documentation, guidelines, staff information, patient information and competences had all been completed. The documentation will be piloted in mid 2012.

Conclusion All staff were supportive and recognised the benefits of this care, not only for the patient and family carers but for them as well.

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