Background Rowcroft Hospice’s strategic aim is ‘taking care further’. This includes providing greater access to services and end of life care for people with non-cancer diagnoses. Working with Devon Partnership NHS Trust an intervention was developed to offer people post diagnosis with dementia, and their families/carers in South Devon. The ‘Planning Ahead’ session is delivered as part of a ‘Memory Matters’ course.

Aim

• 4 weekly 2 hour sessions for those recently diagnosed with dementia and carers.

• Informal introduction to advance care planning - focus on changing ability to communicate and make decisions in the future.

• Provision of information about the legal framework and support tools.

• Promote choice – place of care, preferences, hopes and wishes, nature of medical intervention etc.

• Provide a supportive and safe group to explore these issues.

Approach An informal psycho-education group. The use of group discussion enables individuals to talk about personal experiences/concerns. This facilitates the sharing of information and literature specific to planning ahead. We used mixed media including: video clips, hand-outs, power point, local and national booklets.

Outcomes Initial evaluation by participants:

• Improved understanding about decision making in the event of changes in communication/capacity.

• These conversations are difficult to have/or start in families without support.

• Peer support/normalising effect of the group has been helpful.

Observations of facilitator:

• Shared opportunity to start difficult conversations.

• Carers empowered to consider their own preferences and wishes – the universal relevance of planning ahead for all.

• Individuals with dementia who attend need support to participate and encouragement to be involved.

• Carers/family members can dominate.

Application Advance Care Planning is a cornerstone of Specialist Palliative Care. Developing bespoke ways to meet the varying needs of different patient groups and their families is essential.