Advance Care Planning: moving from telling to asking people

16 April 2015

Becoming a facilitator rather than a dictator of care…CHERYL CALVERT, a gerontology nurse specialist, shares the profound difference becoming an Advanced Care Planning facilitator has made to her practice

Are we shifting the paradigm? Yes, I believe there is a positive swell of change encompassing the way health and care is being approached.

People are talking. People are listening. These conversations are changing attitudes. Fresh attitudes are being transferred to our clinical practise with a positive impact and that change is exciting to be a part of. 

For the last five years I have worked with Auckland District Health Board's Gerontology Services. My clients are 65 years and over and, more often than not, face life with chronic health conditions which significantly impact on their lives and the lifestyles of those who walk with them.

Previously, I nursed people with dementia and prior to that I worked in the mental health sector. With this and a few years of life experience under my belt, I thought I was an able communicator. Taking an honest look at my professional practice, identifying areas for improvement, training and moving forward has been a huge challenge for me 

Initially, standing up in front of my highly skilled colleagues to beat a new drum, felt like I was running the risk of being the emperor with new clothes. All fears abated and I am drumming with passion for Advance Care Planning and extolling the benefits of putting into practice Conversations That Count.

In 2012, I completed the National Advance Care Planning Level 2 Practitioner course.  Has it influenced the way I interacted with people? Yes. I have positively changed the way I engage professionally. The rewards have been numerous, tangible and cumulative.

When I moved from telling people, to asking people what is important to them, a powerful rebalancing of health and welfare ownership occurred. People feel heard, empowered and supported in their health care planning. When whānau and professionals appreciate the rational for a person’s preferences more clearly, these preferences for care become woven into the process of care planning with empathy and compassion instead of being dismissed.

This open and honest exchange of information is vital to ensure issues are defined and the care pathway is re evaluated as that person’s health needs change. With the person the central focus, they become the driver and I become a facilitator instead of a dictator of care. Professionally it’s a nice place to be. 

The elephants in the room and the difficult conversations don’t disappear however for me, the temptation to avoid them or leave them for someone else to have has.

Time is precious – our clients’ and ours. Giving someone the opportunity to identify their issues and prioritise their care needs has, I’ve found, facilitated a more positive and productive approach to the process of planning life and planning for end of life.

Having seen the difference a fresh approach made to my practice, I went on to complete the Advance Care Planning Level 3 Facilitators course. Level 3 Facilitator course teaches you to deliver Level 2 Practitioner training.  Each course I have delivered has been an honour to be part of. I’m constantly humbled by people’s experiences and enriched by the sharing that occurs.

New Zealand’s Conversations that Count Day, 16 April, is about all of us starting conversations with our partners, families, friends, colleagues and health care facilitators so we share what is important to us about our future health care. Developing an Advanced Care Plan helps people, their families and their healthcare teams plan for future and end of life care. This makes it easier for families and healthcare providers to know what the person would want - particularly if they can no longer speak for themselves.

For more information see:

www.advancecareplanning.org.nz

www.conversationsthatcount.org.nz

 

 

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