Supporting advance care planning during Covid-19 pandemic

Two HammondCare clinicians are to feature on heavily subscribed national webinar panels aimed at supporting doctors, nurses, aged care workers and health professionals in providing advance care planning information, advice and assistance to residents, clients and patients during the Covid-19 pandemic.

Offered by Advance Care Planning Australia (ACPA), the first webinar panel on April 23 from 2pm, 'Advance care planning, COVID-19 and Aged Care Professionals’, includes HammondCare Clinical Nurse Consultant, Kelly Arthurs – who is the clinician mentor with The Advance Project and has extensive experience providing palliative care support in residential care.

Meanwhile the second webinar panel on April 28 from 6.30pm, ‘Covid-19 and ACP Webinar for General Practitioners’, includes Dr Joel Rhee who is a GP with HammondCare's Centre for Positive Ageing and Care and A/Prof of General Practice with the University of Wollongong.

Sharper focus on advance care planning in aged care

Kelly Arthurs 300Kelly Arthurs CNC said that open conversations, good information and clearly documented wishes are especially crucial to support advance care planning for people living in residential aged care during the Covid-19 pandemic.

“I agree with Advance Care Planning Australia (ACPA) when they highlight that, sadly, many older people and those with chronic illness are having to contemplate the prospect of becoming suddenly unwell due to Covid 19, meaning that advance care planning in residential care is more critical than ever," Ms Arthurs said.

"Today more than ever open and honest conversations are crucial to enable people living in residential aged care to be kept comfortable and well cared for.

“Effective communication to ensure families are well informed and supported is a key component of advance care planning in residential aged care during the COVID-19 pandemic.

“We all need to work together to ensure we know how residents want to be cared for, and that those wishes are clearly documented.

“Good forward planning is needed to ensure residents who, for example, don’t want to go to hospital, don’t get transferred, and that systems are put in place to support staff to care for people with COVID-19 if needed.”

Advance care planning can help ‘immensely’ in Covid-19 context

DrJoel RheeAccording to HammondCare’s Dr Joel Rhee – whose research focus is advance care decision-making and GP involvement in palliative care – ‘small talk’ during consultations is now often turning to the pandemic.

“Patients are often concerned and anxious about COVID-19 especially given the rapidly changing situation and widespread misinformation circulating in social media,” Dr Rhee said.

“Not only is this ‘small talk’ an opportunity to address concerns, but where appropriate, to help people consider advance care planning," he said.

“Discussion about Covid-19 in the context of Advance Care Planning should centre on provision of information and helping the patient and loved-one prepare for decision-making that may or may not be required in the near future.

“These discussions are relevant for everyone but even more so for people aged over 70 or those with pre-existing health conditions.

“Providing an opportunity for family members to hear what the patient wants in care will help them immensely in making decisions they can feel at peace with, confident that they carried out what their loved one wanted.

"Some decision-making may be out of the hands of patients where treatments have very little likelihood of success, but in many cases, the patient or their representative will be asked by health care teams about their care preferences such as life-sustaining treatment, hospital transfer from a nursing home, ICU admission or whether CPR is to be provided."

Dr Rhee said that COVID-19 is a serious disease from both a population perspective due to the sheer number of unwell people, and from an individual perspective as around 1 in 5 infected persons will require hospital admission and the chance of death ranges between 0.1% or lower in younger people to more than 15% in older people with pre-existing health conditions.

Find out more about HammondCare's palliative care services