Start a conversation that counts

It’s not easy to talk about planning for your future and end-of-life care, but it is important. 

You may not have heard much about Advance Care Planning (ACP), but it’s something all of us will need to think of at some stage, for ourselves, our loved ones  and for our patients. Advance Care Planning is all about choice – choosing how you want to be treated at the end of your life. The concept is not new, and New Zealand is a bit behind the rest of the world in dealing with this sometimes challenging issue.  Today (16 April) is Conversations that Count Day – a national initiative led by a co-operative of hundreds of people across New Zealand’s health system that is encouraging us to have a ‘Conversation that Counts’. That is, talk to those we care about and with those who will care for us as the end approaches about what we would want for ourselves.

While end of life care isn’t an easy subject for health professionals to bring up, ACP can be a welcome topic for patients who may be worrying about the sort of care they will receive, but have been reluctant to discuss it with their whaanau.

Research shows us that the sense of control and peace of mind that this process can foster in the patient and the reduction in anxiety for the family are important benefits.  We all potentially have lots of time to think, talk and plan for our future and end of life care. Many people don’t spend their last weeks and months doing what they value in a place they call home. They are undergoing treatments they would not have chosen given the choice, away from their homes in a hospital or high care facility, isolated from their families by visiting hours or distance.  Many don’t get to say what they want to the important people in their lives, don’t get to say I love you, thank you, sorry and goodbye.
  
We as health professionals may also feel ‘awkward’ about getting into this, but the right training and having the right resources to assist with the legal and ethical issues involved can support the process enormously. And we are going to need these skills more and more in the future as we embrace more patient-centred care and treat more assertive and informed generations.

In the long-term I would like to see all of our patients being offered this valuable tool early on in their illness, giving the patient and their whaanau an opportunity to engage in all aspects of their care.  When it comes to the stage where a patient is unable to speak for him or herself, the advance care plan speaks for them, providing clarity around the care they want to receive and peace of mind for the whaanau and health professionals knowing they are following out the person’s wishes.

To find out more about Advance Care Planning, access  e-Learning modules or watch the moving and very informative film Living for Today, Planning for Tomorrow, visit www.advancecareplanning.org.nz.

Geraint

 

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Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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