MOLINO DE CUBO.

The following information has been designed to assist you in understanding the process and importance of advance care planning for a resident with advanced dementia. This process enables aged care staff, the resident and their family to benefit from documentation that provides guidance as to the preferred course of action, in the event of future health problems or deterioration of the resident. It enables decisions to be documented in advance so that the wishes of the resident (or ‘person responsible’) can be respected. The process for future or advanced care planning differs depending on the cognitive capacity of a person to make his or her own health and medical decisions.

Who Can Be Involved in Advance Care Planning For a Person with Advanced Dementia?

Discussions related to the future care should ideally involve the resident. However, in circumstances when they do not have the capacity to articulate their own wishes, in relation to their medical and personal care (for example people with advanced dementia), it is possible for a ‘person responsible’ to make these decisions on their behalf. The person responsible can state their wishes for the resident’s health care based on what they believe is in the resident’s best interest and consistent with what the resident would have wanted.

Advance Care Planning and Plan of Treatment

The process of advance care planning requires that you have an understanding of the person’s heath status and what decisions you might need to make related to their future care. Staff at the aged care facility and the person’s GP will be able to assist you to understand this. You will also need to consider the wishes of the person with dementia and what they would have wanted for their future care.

A Plan of Treatment is part of the advance care planning process. It is a written document completed by the ‘person responsible’ that outlines their wishes and preferences for the resident’s future care medical and personal care, especially related to end of life care. This information helps to guide staff when providing care to the resident.

Who is the person responsible?

The ‘person responsible’ is not necessarily the person’s next of kin (but in many cases they may be). The person responsible is a concept defined in law and it applies to adults who have a disability and who are incapable of consenting treatment/care options. For adults, the ‘person responsible’ is in the following priority order:

• A guardian (including an enduring guardian) who has the power to consent to health care, which includes the power to withdraw consent to treatment;

• A spouse, including de-facto spouse – with whom the patient has a close and continuing relationship;

• An unpaid carer who is now providing domestic services or support to the patient, or who provided these services and support before the patient entered the residential facility;

90 • A relative or friend who has both a close personal relationship and a personal

interest in the patient’s welfare.

(Note more information about the ‘person responsible’ can be obtained from the Guardianship and Administration Board).

As the ‘person responsible’, it is advisable that you take the Plan of Treatment form home and have time to read and consider it. You may wish to discuss the information with others who have a significant interest in the resident’s care (i.e. family members; GP). It is important that you communicate your wishes for the resident’s future care with the aged care staff so that they are aware of your wishes, can discuss these with you and answer any questions you may have. Thus it is advisable that you meet with staff from the facility, who provide care for the resident to share your wishes and have them documented appropriately.

How Do I Change or Revoke The Plan of Treatment?

Plans of Treatment are reviewed regularly by staff at the facility in consultation with the person responsible. If the person responsible wishes to change or revoke the document, they will need to notify the trained staff either verbally or in writing. Changes to the document will also need to be signed by the person responsible.

If you have any further questions in relation to advance care planning please feel free to approach any of the following staff: [Person 1] ([The SCU]), [Person 2] ([The SCU]) or [Person 4] (Nurse Supervisor), PH: [number]

91

Appendix 28

To the staff members of the SCU,

The research project entitled, “Developing a palliative approach for people with

dementia in a residential special care unit” continue to be conducted on the SCU.

The study is for a PhD project conducted by Sharon Andrews. The aim of the study is to investigate how care practices of staff may be developed around a palliative approach to improve the provision of care for residents on the unit and their family members.

Within this stage of the project the research team will be trialling a number of interventions on the SCU. One of these interventions will be the conduct of education sessions, which will cover aspects of a palliative approach and pain management for people with dementia. Other interventions, which will be undertaken on the unit, will also be discussed at the education sessions.

Staff are invited to attend one of the below scheduled sessions:

<Date > : < time> < Date> : < time>

Your attendance is voluntary. These sessions will be held in the meeting room at the facility. Dates and session times will also be displayed on the noticeboard on the SCU.

Your participation in one of the above sessions would be greatly appreciated and will make a valuable contribution to the research and the development of improved care practices on the SCU. The staff of the unit have been very supportive of this project in the past and we hope that this support can continue during this stage.

If you have any further questions about the research please feel free to contact Sharon

at [email protected](03) 62[xxxxxx].

92

Appendix 29