Plan Ahead, For Tomorrow: Insights To Advance Care Planning
Mr William Hoo from SATA CommHealth answers some frequently asked questions about ACP.
Mr William Hoo
Case Manager, SATA CommHealth
"1. What is Advance Care Planning, and what does a Nominated Healthcare Spokesperson do?"
Advance Care Planning, or ACP, is a formal process for planning and sharing how an individual wants to be cared for in the event of a critical illness or serious injury, where they are no longer able to make their own decisions. Individuals will share their personal values and beliefs, explore their healthcare preferences in difficult medical situations.
They will also think about who can be their voice if they become very ill one day. A Nominated Healthcare Spokesperson (NHS) will play the role of representing the individual’s views and preferences when they no longer have the mental capacity to do so.
"2. Is it more useful for someone in their later years when they know what they want? Can I change my mind after doing my first ACP?"
ACP is for anyone 16 years old and above and who has the mental capacity to make their own decisions. Whatever our age, we all have values and preferences for how we want to be treated. It is important to think about these choices and start planning when we are still healthy before there's an emergency.
This ACP document follows you through your life journey, and it should be reviewed after a significant medical diagnosis, or after a significant change in one’s daily functioning (*Activities of Daily Living). These revisions can include changes to the NHS, medical treatment, or long-term care preferences.
*Activities of Daily Living include:
- Walking or moving around
"3. How do I start planning my ACP? What are some of the questions that will be asked? "
The first step to ACP is to reflect on:
- Your definition on quality of life
- What activities and experiences give your life meaning
- What goals are you hoping to achieve
- What religious or cultural beliefs you have
An ACP booklet can be downloaded from AIC’s website to document the thought process.
The next step is to talk to your NHS about your care preferences in the event of a serious illness or injury. When choosing an NHS, it is important to think about how well you know them, how well they know your care preferences and beliefs, and whether they can follow your care wishes in stressful situations. The final step is to book an appointment with an ACP provider for a discussion.
"4. How would you recommend we start the ACP conversation? Is this best done in a private setting, or can it be done over coffee in a cafe?"
During an ACP conversation, client will be sharing personal information (eg. family background, medical history, medical treatment preferences, etc.) with the ACP facilitator and NHS. Hence, the discussion needs to be held in a private setting where the client can feel safe and share their wishes in confidence.
"5. Do you have a real-life example of how ACP helped a client?"
SATA CommHealth offers General ACP to individuals who are generally healthy or may have experienced an early onset of a chronic illness. In our course of work, we have encountered numerous clients who have experienced their family or friends becoming seriously ill. And through these crises, they realised the importance of making their medical treatment preferences known to their loved ones, so that they can make an informed decision on their behalf.
"6. Why do I need an ACP facilitator? Can I do it on my own?"
An ACP facilitator acts like a guide to help individuals navigate the process with their NHS. The facilitator will also assist in the documentation & upload completed ACP form to the National ACP IT System.
During an ACP conversation, you will be sharing your views and beliefs about life, health and end-of-life with the facilitator, and NHS. That will largely determine your goals of care (life sustaining treatment vs comfort-focused treatment). The facilitator’s role is to clarify and ensure that your values and beliefs align with your preferred medical treatment.
"7. What is the cost of doing ACP? Must I pay each time I revise my ACP?"
ACP service is currently free of charge at SATA CommHealth’s medical centres for Merdeka Generation, Pioneer Generation, CHAS blue or orange card holders. For those without the mentioned cards, the cost is $42.80 (nett).
There are no charges if minor changes (eg. changes to personal or NHS particulars) are required. However, if major changes (eg. changes in NHS or medical care preferences) are needed, the above prevailing rates will apply.