Advanced Care Planning Theory

Advanced care planning encompasses a collaborative approach, which includes not only the patient, but the family, clergy, caregivers, nurses, and physicians as well. The goal of the planning process is to establish the wishes of the patient in advance of adverse system responses, in addition to completing any legal documents that will specify the treatment specifics. The purpose of this proposed change is to guarantee the establishment of this advanced care plan early in the hospice process, in an effort to avoid any restraining forces that would inhibit holistic care for the patient. By educating all parties earlier in the process, the likelihood of emotions preventing rational decision-making is avoided. When the potential for harm from continued administration of artificial nutrition and

It is vital to encourage all members of the team to change their current perspectives in order to move towards a more effective mode of operation (Kaminski, 2011). Empower the palliative care team through education. “Organizational members need to feel worthy and psychologically safe, that is, to have no fear of retribution or punishment for embracing the change” (Burke, 2011). In-service training will be provided to all members of the palliative care team. First, reinforcement of thorough assessment skills is mandatory. The clinical manifestations of unfavorable system responses related to the continued administration of nutrition and hydration must be recognized. In addition, the assessment of signs and symptoms of eminent death are important to recognize (City of Hope, 2007). Also, education pertaining to the necessary legal documents is essential. The early establishment of advanced directive and durable power of attorney must take place. Therefore, all parties involved are aware of the wishes of the patient at a time when emotions would not represent a barrier to effective