Discussions about end of life issues and planning for care can be difficult for clinicians to initiate. These discussions are multifaceted and take into consideration a range of goals.
Research on end of life decision-making has identified six major types of patient goals:
There is also evidence that advance care planning positively impacts on the quality of end of life care. Complex advance care planning interventions involving multiple conversations and planning tools over time may be more effective in meeting patients’ preferences than written documents alone (Brinkman-Stoppelenburg et al, 2014)[2].
The Agency for Clinical Innovation commissioned CareSearch (Palliative and Supportive Services, Flinders University) to identify local, national and international tools or resources that can potentially be used to implement each of the ten (10) Essential Components of Care within the Blueprint.
To be included, tools and resources were required to be in English, be applicable to the Australian context and be supported by evidence (such as published validation studies, clinical guidelines representing expert consensus, or advice from expert clinicians who were consulted).
The set of tools and resources provided is not intended to be exhaustive, nor is any one tool specifically recommended.
Advance Care Planning Australia
Australian website featuring information about how healthcare professionals can have conversations with people regarding their future healthcare desires in clinical settings. Includes links to recent publications pertaining to end-of-life care planning and practice implications.
An aid for cancer patients, the Question Prompt Lists (QPLs) encourage questioning, thereby assisting them to take up a more active role during visits with their medical specialist.
Needs Assessment Tool: Progressive Disease (NAT-PD)
Clinical assessment tool aiming to assist in matching the types and levels of need experienced by people with progressive chronic diseases (e.g. cancer, heart failure, COPD) and their caregivers with the most appropriate people or services to address those needs.
Needs at the End-of-Life Screening Tool (NEST)
Clinical assessment and outcome measurement instrument for end of life care (Needs, Existential, Symptoms, and Therapeutic).
NSW Trustee and Guardian services
Providing a full range of Will and Trustee services and can be appointed by a court or tribunal as a financial manager and guardian to support some of the state’s most vulnerable people.
Family meetings in palliative care: multidisciplinary clinical practice guidelines
Guidelines for health professionals working with cancer and palliative care patients developed by the Centre for Palliative Care Education and Research in 2009.
Multidisciplinary Case Conferences
Commonwealth Government specifications for MBS payments for multidisciplinary case conferences.
Multidisciplinary meetings for cancer care: A guide for health service providers
National Breast Cancer Centre produced guide (2005) for health service providers and multidisciplinary team members with ideas and tools to improve multidisciplinary care at a local level.