Advance Care Planning

from Wikipedia, the free encyclopedia

Advance Care Planning ( ACP , German also health or predictive care planning ) is a concept for and with a patient in order to design his treatment and care in his own way. On the basis of a continuous, structured advisory and support process, possible expectations are determined and formulated clearly and understandably. This ensures that the patient is fully informed and informed and that the respective treatment team and their relatives are aware of their wishes. In this way, the presumed will of the person concerned can also be represented in situations in which they are no longer able to do so themselves. In this respect, ACP represents "a dynamic form of living will ".

background

Advance Care Planning arose from the motivation " to counteract unnecessary hospital admissions, incorrect or misinformation in a specific action or emergency, in a crisis or the process of dying ."

The idea and conception of the ACP originated in the USA in the early 1990s. In Germany, the concept, which has been further developed several times since then and which has already been firmly established in various English-speaking countries, was taken up in the model project "accompanying in good time" from 2008 onwards. The "German Interprofessional Association - Planning Treatment in Advance (DIV-BVP) eV" is a scientific society that advocates the implementation of "timely support" by training facilitators.

A legal basis for implementation in the German health system was created with the Hospice and Palliative Care Act, which came into force in 2015 .

Definition of the ACP-i

The organization Advance Care Planning international (ACP-i) defined Advance Care Planning in 2016 as a “communication process between individuals, their legal representatives and their treating and caring staff. It aims to understand, rethink, discuss and plan possible future treatment decisions in the event that those affected cannot decide for themselves. This process can be facilitated by a specially trained professional or as part of routine care by the health professionals accompanying the person. "

In German, there is currently no standard translation for ACP. So ACP z. B. as "planning treatment in advance" (BVP), "forward-looking treatment planning", "health care planning", "forward-looking care planning" or "forward planning of health care".

Conception

ACP is defined as a continuous discussion process between the (potentially) affected person, possibly his legal representatives or authorized representatives, the treating and supervisors. The control is carried out by specially trained moderators, preferably from non-medical health professions. The process includes counseling and case discussions in order to better understand specific emergency situations and to make decisions for your own treatment. The consultation process and voluntary decisions of those affected are documented in writing.

A central feature of the ACP is that the conversations should be offered actively (so-called outreach conversation offer, so far mainly for residents of old people's homes ). In order to be able to record and take into account any changes in the patient's will, renewed discussions are offered at regular intervals, but in any case when there are changes in the personal life situation.

literature

  • Klaus Wegleitner, Elisabeth Medicus: Palliative treatment plan and ethical framework. In: Klaus Wegleitner, Katharina Heimerl, Andreas Heller (eds.): To die at home - death does not stick to duty rosters . the hospiz Verlag, Ludwigsburg 2012; ISBN 978-3-941251-50-2
  • Michael Coors, Ralf Jox, Jürgen In der Schmitten (eds.): Advance Care Planning - from living wills to advance health planning. 1st edition, Kohlhammer, Stuttgart 2015; ISBN 978-3-17-028674-0

Web links

Individual evidence

  1. ↑ Advance Care Planning: A dynamic form of living will. Retrieved July 10, 2019 .
  2. ↑ Klaus Wegleitner, Elisabeth Medicus: Palliative treatment plan and ethical orientation framework. In: Klaus Wegleitner, Katharina Heimerl, Andreas Heller (eds.): To die at home - death does not stick to duty rosters . der hospiz Verlag, Ludwigsburg 2012, p. 220
  3. ↑ a b c Advance Care Planning (ACP) in inpatient care facilities. An introduction based on the Hospice and Palliative Care Act (HPG). Deutscher Hospiz- und PalliativVerband eV, February 23, 2016, accessed on July 10, 2019 .
  4. ^ Teaser - Journal of Medical Ethics. Retrieved July 10, 2019 .
  5. ↑ Living will : treat as discussed. Retrieved July 10, 2019 .
  6. ↑ The DiV-BVP. In: divbvp. Retrieved January 15, 2020 (German).
  7. ↑ Federal Law Gazette . Retrieved July 10, 2019 .
  8. ↑ ACPEL-Society 2016, accessed on July 10, 2019. Translation from English
  9. ^ German Hospice and Palliative Association eV: Advance Care Planning (ACP) in inpatient care facilities. An introduction based on the Hospice and Palliative Care Act (HPG). P.3 ; accessed on July 10, 2019
  10. ↑ Handout: Health care planning for the last phase of life. Implementation of the agreement on the content and requirements of health care planning for the last phase of life in accordance with Section 132g (3) SGB V. Bundesarbeitsgemeinschaft der Freie Wohlfahrtspflege e. V. (BAGFW), April 2018, accessed on July 10, 2019 .