Respecting Choices and Disease-Specific Advance Care Planning

Respecting Choices Disease-Specific Advance Care Planning: The Next Steps for Patients with Chronic Progressive Illness

Respecting Choices has a long history of developing advance care planning (ACP) programs that produce successful outcomes. For the past several years, they have been testing and refining an approach to ACP for patients with chronic, progressive illness called “Disease Specific - Advance Care Planning” (DS-ACP). Through research and clinical implementation, they have developed the expertise and strategies for successful replication.

Why is Disease Specific ACP Important?

• Millions of people live with—and eventually die from—a variety of chronic illnesses, experiencing sudden but predictable complications for which they are unprepared.
• Only one-third of patients with chronic, progressive illness have completed some type of written advance directive.
• Even when written plans are created and available, they are often not helpful because chosen healthcare agents are not prepared to make specific decisions (often choosing more aggressive treatment than their loved ones would choose) and instructions provided are too vague or ambiguous to guide clinical decision making when needed).
• The 2008 Dartmouth Atlas report identifies wide variability in care and related costs of patients with chronic, progressive illness in the last two years of life. This raises the concern that some patients might be receiving more interventions than they want or can benefit from.
• Patients with chronic, progressive illness report a need for information on treatment survival and outcomes in order to make informed healthcare choices. They also express a desire for information about treatment options, benefits, and burdens.
• The 2008 Report to Congress calls for a shift from advance directive completion to patient-centred communication strategies that assist patients in making informed healthcare decisions.

Find out more about Disease Specific ACP on the Respecting Choices website. Contact me or Matthew Isbell at the Gundersen Lutheran Medical Foundation: 800.362.9567  (Ext. 54747)