1 / 19

Best Interests Care Planning for people with Advanced Dementia

Best Interests Care Planning for people with Advanced Dementia. Tina Kukstas, Consultant Nurse: Dementia 2 gether NHSFT. Support to adjust to a diagnosis Advance Care Planning. The experience of dementia. Support for dementia as a long term condition. End of life; Advance

allendamon
Download Presentation

Best Interests Care Planning for people with Advanced Dementia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Best Interests Care Planning for people with Advanced Dementia Tina Kukstas, Consultant Nurse: Dementia 2gether NHSFT

  2. Support to adjust to a diagnosis Advance Care Planning The experience of dementia Support for dementia as a long term condition End of life; Advance Care Planning (Best Interests) Diagnosis

  3. What is advance care planning when a person has capacity? A way to identify: • Statements of wishes and preferences • Advance Decisions • Naming a person /persons to become power of attorney for welfare/finances • End of life planning

  4. Temporal Lobe. • Memory store; accessing memories to make orientate • Expressive Language; finding the words to express yourself or words for objects (Aphasia) • Receptive ability; using & understanding spoken words • Taking on board information; recognising objects (Agnosia)

  5. Dementia = Frontal lobe difficulties with… • Planning & Organising • Concentrating & taking in information • Considering options and weighing them up • Connects past, present, future; Conceptualising

  6. What does this mean? Opportunity to engage in advance care planning becomes compromised as a person’s dementia progresses

  7. Advance Care Planning (anticipatory planning)Best Interest Decisions ……when a person no longer has capacity this provides a framework for best interest decisions to be made at a time when a person is no longer able to make decisions for themselves Any former advance care planning made by the person (prior to them losing capacity) will be essential to feed into the relevant best interest decisions that can be made once a person is unable to make those decisions

  8. Best Interests Checklist • Giving equal consideration and non-discrimination • Considering all relevant circumstances • Regaining capacity • Permitting and encouraging participation • Special considerations for life-sustaining treatment • The person’s wishes and feelings, beliefs and values • The views of other people

  9. Types of Best Interest Planning for people with advanced dementia Decisions relating to: • Cardio Pulmonary Resuscitation (CPR) • Non acute admissions to hospital • Artificial nutrition and hydration (ANH)

  10. Background to the Best Interest document • Initially developed as an additional resource to the Advance Care Planning document.(2013) • Advance Care Planning document = people with capacity to make decisions about future care and treatment at end of life for a time where they may lack capacity in this area of decision making • Best Interest Document = people without capacity to make decisions about end of life care and treatment.

  11. Other formats to provide anticipatory care planning • Patient Treatment Options Form (PTO form) • Forms from various organisations; Alzheimer's Society • Self made forms

  12. Benefits of Advance Care Planning • advance care planning, both when a person has capacity and when a person loses capacity (advance care planning in best interests), can help to reduce unnecessary emergency admissions to hospital and improve the quality of end of life care • advance care planning may help to ensure better use of health and social care resources.

  13. Dementia as a life limiting illness • Dr Liz Sampson from the Marie Curie Palliative Research Unit says in many care homes and hospitals this can be a difficult step. • "I think people who work in medical and social care are finding it very difficult to recognise that point at which you change the goals of care. And often that step comes too late, and unfortunately people may then die in an acute hospital or an A and E department on a trolley."

More Related