According to the U.S. Centers for Disease Control and Prevention, approximately 70% of Americans don’t currently have an advance care plan. Advance care management is critical for empowering patients, especially when a patient and their loved ones are dealing with one or more forms of cancer. Any type of health care planning made throughout treatment can only help a patient and everyone who aids in their medical care.
Yet, many people don’t know much about advance care planning. This guide outlines the most critical points every doctor, patient, and caregiver needs to know.
What Is Advance Care Planning?
Advance Care Planning (ACP) describes when a patient and their social support system work with their medical team to prepare for a time when they might not be able to vocalize or cognitively make health-related decisions. This advanced health care management type is commonly associated with chronically ill, elderly, and terminal patients. However, it can benefit any patient at any stage of their life, regardless of age or health status. The sudden onset of a serious illness like cancer and major accidents and other life events can lead to severe debilitation.
You might also hear this type of planning described as “advanced care planning.” “Advance” refers to carrying out a task or preparing ahead of time. The term “advanced” describes something further along in time, at a higher level, or more difficult or complex. As a result, you might see the two terms incorrectly used interchangeably, or the latter used correctly to describe a complex version of health care planning and management.
What Are the Benefits of ACP?
No matter what you call it, the primary goal of this form of advanced healthcare management is empowering patients by guaranteeing that all provided health care services match precisely a patient’s goals, preferences, background, beliefs, and values. The most apparent advanced care benefit is that patients can make informed decisions about their future while they’re still able to give their input to their team. Additionally, their caregivers or loved ones don’t have to make complex, heartbreaking decisions, such as decisions about end-of-life care, because they have already clearly and legally outlined their desires in writing.
An advanced care plan promotes bodily or body autonomy, enabling the idea that an individual has the right to make decisions about what happens to their body. It also guarantees that medical personnel provides high-quality, patient-centered care more efficiently and optimally using available health care services and tools to help the patient. As time passes and the patient’s life and health change, the patient and their team continue to discuss and modify the advanced care plan as needed.
What Are ACP Documents or Orders?
If you’ve been to an ER or urgent care center, you might have been asked by a nurse or doctor if you have an “advance directive,” “portable medical orders,” “living will,” or a “power of attorney.” States use different terms to describe one or more advance care documents that outline emergency and end-of-life treatment and other wishes if you can’t communicate. These documents all provide similar advanced care instructions.
For example, a patient might have a written advance directive that makes it clear that medical staff shouldn’t resuscitate them (Do Not Resuscitate or DNR order) if their heart stops beating. They might indicate that they don’t wish to be placed on life support if they can’t breathe on their own or receive a feeding tube or palliative care. A health care or medical POA, also known as a durable POA or health care proxy document, offers a different approach. The patient indicates with the document that they’ve chosen another person to make health care decisions for them, which can apply to emergency and end-of-life care required when incapacitated.
How Is Advanced Care Planning in Oncology Different?
There aren’t many differences between ACP for patients dealing with cancer and other chronic illnesses. Many chronic diseases eventually lead to decline, debilitation, and long-term disability or a terminal state. A cancer patient may need to outline in an advanced care directive whether or not they wish certain types of treatment if they’re no longer capable of speaking, including but not limited to chemotherapy, a port, or radiosurgery. A cancer patient might also decide that they don’t want surgery if it means they might permanently need a colostomy bag or feeding tube. State laws can impact these and other decisions.
Yet, it’s now more important than ever that cancer patients utilize advanced care management. Without health care planning, confusion can occur during an inpatient stay at a hospital, medical facility, or home where loved ones and others provide basic caregiving services or palliative or hospice care. You might not receive the care you desire, or your family members and others might disagree and possibly fight physically, verbally, or in court over how to handle your care or, if applicable, end-of-life wishes. Without instructions from you, they might experience health-damaging emotional distress, a breakdown of their relationships, and financial harm.
Many cancer patients rely on Medicare for part or all their insurance coverage but don’t know that their doctor can offer advanced care management services during covered wellness visits. Known as Voluntary ACP, the patient can talk about this type of plan or fill out related forms with help from their doctor during the visit. Medicare and other types of insurance count ACP as either a part of the wellness visit or a separate, Part B cost-sharing medically necessary service.
About Horizon Oncology
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