The case for prioritising advance care planning in COVID-19 response

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Dr Chris Moy

A new report has recommended that advance care planning could be better used as part of Australia's COVID-19 crisis to help manage a surge in healthcare demand and reduce the need for rationing.

The report, Advance care planning in Australia during the COVID-19 outbreak: Now more important than ever, recommends that more advance care planning (ACP) conversations should be happening now with older Australians and those with chronic conditions. This may help to avoid scenarios where people who are hospitalised with coronavirus and prefer to avoid invasive treatment, are not unnecessarily 'competing' with people who would want it.  

With parts of Australia experiencing a second wave, the COVID-19 pandemic poses ongoing risk to the wellbeing of older Australians – both through the virus itself, and also for those who are living with ongoing illnesses. As it currently stands, 75% of older Australians do not have a plan to guide their treatment, should they become suddenly unwell, meaning that decisions will be made for them. ACP helps people advocate for the type of care they would want, if they were unable to speak for themselves.

The report was developed by researchers and clinicians from Advance Care Planning Australia (ACPA), and makes a case for prioritising advance care planning during the pandemic. It presents the benefits of encouraging people to state their preferences and plan their care now, so that the individual, their family and doctor are prepared for a time that a health crisis occurs and they're no longer able to make their own treatment decisions.

At a policy level, this report recommends that the Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) be updated to incorporate a more strategic approach to increasing system-wide ACP implementation. As it currently stands, the plan contains just one vague reference to ACP, lacking detail about how it should be coordinated.

The report identifies key recommendations for the health sector including increasing health and aged care workforce competency in facilitating ACP, ensuring systems are in place to store and access ACP documents, such as My Health Record and for GPs to make ACP conversations a routine part of care, which may be delivered via telehealth.

"Most of us expect to have a say in our medical treatment, however when events change suddenly, people may be left without a voice or choice, if no plan is in place. I encourage all Australians, but particularly older people, and those with chronic illness such as heart disease or cancer, to talk to your doctor about your situation and preferences. A little planning today, may save a lot of stress tomorrow," said Dr Chris Moy, Adelaide-based GP and Vice-President of the AMA.

"These conversations may make some people uneasy, however as a GP, I know there are many people who feel strongly about being prepared and having their choices respected. They have the right to be heard," said Dr Moy.

"We know that the health and aged care workforce are under immense pressure right now. We're here to support them with ACP advice and free online learning and resources," said ACPA Program Director, Linda Nolte.

"Whether you're a GP, someone working in aged care or a person needing advance care planning advice, we're here to help. ACPA operates a free National Advance Care Planning Advisory Service," said Ms Nolte.

The ACPA National Advisory Service operates Monday–Friday (AEST). Free call 1300 208 582.

 
Community Coronavirus COVID-19 Health & Wellness Law & Safety Seniors
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