Think Ahead – A Complete Guide to Advance Care Planning
Think Ahead is a practical guide for advance care planning and end of life that can be used in any setting, including a nursing home. Think Ahead helps nursing home residents document their healthcare choices, values, and preferences for care at end of life. Think Ahead can be completed alongside your organisation’s established advance care plan documentation, and as a complementary tool to guide conversations and identify the residents’ preferences for end-of-life care.
We all value and prefer different things, and this is no different when you move into a nursing home. It is important every nursing home resident is given the opportunity to consider, discuss and share these thoughts with family, friends, and the healthcare team. Think Ahead helps protect the residents’ choices, even when they are unable to express them.
To help you with some of these conversations, Think Ahead Planning Packs guide you step-by-step through common topics related to end of life and after death care.
Each Think Ahead Planning Pack has three parts:
A place to record all important information and preferences in case of serious illness, at end of life, and after death. This section is not legally binding but can help ensure that nursing home residents are cared for in ways that meet their physical, emotional, spiritual, cultural, and personal desires.
A place to record requests and refusals of healthcare treatments, and to appoint someone to speak on behalf of the resident. This section is legally binding when signed and witnessed properly – please see below.
A place to summarise the choices made in the Personal Wishes & Care Plan and in the Advance Healthcare Directive, to share with the nursing home staff and GP.
The Advance Healthcare Directive included in the Think Ahead Planning Pack became a legally binding document with the commencement of the Assisted Decision Making (Capacity) (Amendment) Bill on 26 April 2023.
Make sure you know what to look for in an Advance Healthcare Directive. In order to be legal, the document must be signed and dated by the Directive Maker (nursing home resident), their Designated/Alternate Healthcare Representatives (if appointed), and two witnesses. One of the witnesses may be a family member, but the other one must not be.
Tips for using Think Ahead in your nursing home:
- It’s not a “one and done” conversation – it’s important to revisit these conversations over time. Generally, a person needs to have about three conversations to complete an advance care plan. Think Ahead should be reviewed and updated regularly, for example on admission to the nursing home, when a resident’s condition deteriorates, or during routine care plan reviews.
- Familiarise yourself with the content – you can download Think Ahead for free
- Talk to your colleagues about Think Ahead – could any sections be included in your established ACP documentation
- Approach end-of-life conversations gently and sensitively, but don’t shy away – advance care planning conversations are an important part of your job
- Choose the right time and place. Give yourself time for a comprehensive discussion.
- Ask open ended questions to help guide the conversation:
What does a good day look like for you?
Is there anything You would like to tell us about looking after you in the future?
Have you ever thought about what you might want if you became unwell
Explore further education and training for healthcare professionals, including videos and our ‘Lunch & Learn’ series, at thinkahead.ie