Advance Care Planning strategies – a workshop held in Thailand

Categories: Education.

Even though a law about Advance Directives has been in place since 2007, dispute and unrest are still high among those who work in palliative care, partially due to the lack of knowledge and practical guidelines on the subject.

This workshop, supported by THAPS and Thai Health Promotion Foundation, acted as a vital bridge between palliative care workers and policy makers to discuss key components and strategies that would lead to more success of ACP in Thailand.

The workshop was comprised of two days panel discussion. The first day focused on an easier and more concise definition of ACP for the greater public and individual stories about each person’s experience of ACP.

‘Life road-map’

Interestingly, the consensual new definition of ACP came out as: ‘Life road-map’.

To put it simply, a patient is metaphorically and literally on a journey, with one map at hand, their destination further away.

Before starting their trek, the patient and the family should have an explanation from the healthcare team about their situation and choices. This would include which route they could take and what they would be expecting to find along the road.

Providing that the healthcare team give the patient and their family thorough information, the rest would be up to an individual, whichever road they want to take.

Apart from the newly-coined term, workshop delegates identified four main keys of successful ACP.

1. Healthcare provider

They must have good communication skills, along with a clear understanding of the patient’s situation and needs. The multidisciplinary team and early approach to initiate ACP are also other vital points that contribute to the success.

2. Patient

Adequate symptom control is the first key, because a restless man who is in agony would not want to have a long talk about their goal of care plan at all.

Apart from that, patients who have a good relationship with the team and a clear understanding about their treatment plan have more successful rate of ACP.

Those who have knowledge about Advance Directives or who have made one beforehand, whether in verbal or written form, also tend to have their wishes followed.

3. Family

A family that has the same goal of care plan between them is another contribution for successful ACP. A proxy who is aware of the patient’s condition and wish is another factor that helps, should the patient become incapacitated.

4. Healthcare System

All of the above would not have been possible without a proper system. This includes a palliative care network, a proper and thorough referral system, and also a clear policy that dictates how to support palliative care patients and those who are working in the field.

Strategies to promote Advance Care Planning

The second day emphasised strategies to help improve ACP awareness among healthcare providers and the public, and also the effectiveness of ACP with potential support at hand.

As in the previous Pal2Know workshops, the content of these two days’ panel discussion will be analysed and distributed as a reference book in upcoming months.

The next workshop, to be held in November, will be about: ‘Palliative Care at Home’.

Find out more about Pal2Know’s projects by emailing pal2know.thaps@gmail.com