Aligning preferred care wishes with actual place of care and death

Anticipatory care plan (ACP): “… As a philosophy, promotes discussion in which individuals, their care providers and those close to them make decisions with respect to their future health or personal and practical aspects of care.”

The benefits of anticipatory care planning include the opportunity to promote patient centred care, enhance quality of life and quality of death through empowering individual’s decision making.

Living and Dying Well: Building on Progress.(2011)p.21

Symptom Management: The goal of symptom management should be to prevent or treat as early as possible the symptoms or distress associated with progressing illness. These symptoms may result from a physical, psychological, spiritual or emotional origin.

Priorities of Care include preferred place of care and place of death: Most people are able to identify the location in which they would like to receive care at the end of life. The majority identify home as their preferred place of care and place of death. Implementing this in clinical practice can be challenging particularly for people like Bill who live on their own, who will experience deteriorating health and associated symptoms as well as having very little family support. All of these factors are essential for successful facilitation of preferred place of care and place of death.
Scottish Palliative Care Guidelines 

Effective Communication: The ability to communicate and form effective relationships is essential for the provision of high quality person centred care. Placing the patient at the heart of care is one of the quality aims of the Healthcare Quality Strategy for NHS Scotland (Scotland Government, 2010). Despite the increase in communication skills training there is significant concern that the quality of communication between professionals and patients remains inadequate.
How Healthcare Professionals in Scotland Develop Their Communication Skills, Attitudes and Behaviours. NHS Education for Scotland [PDF]

Bereavement Assessment and Risk: Bereavement assessment and risk information can be used to identify caregivers or family members who may be at risk of a negative bereavement experience. Tools can be used to inform the care team which communicate personal, interpersonal and situational factors that may place a caregiver or family member at greater risk.
Good Life, Good Death, Good Grief