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.
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.