Advance Care Planning
What is the purpose of advance care planning?
To communicate values, wishes, and who will speak for the patient if they cannot.
What is the first step in setting up a serious illness discussion?
Ask permission and prepare the setting (privacy, no interruptions).
What does the platinum rule state?
Do unto others what they would want done for themselves.
What is the first question to assess when talking about EOL care?
What communication skill builds trust and safety?
Active listening.
What document outlines care a person would accept or refuse?
A health care directive.
Why should nurses assess a patient's understanding before giving information?
To align communication with what they already know and correct misconceptions.
In SPIKES, what does the "I" stand for?
Invitation (how much the patient wants to know).
What are some common fears patients may have near end of life?
Pain, suffering, leaving loved ones, or the unknown.
Why is it important to avoid assumptions about patients' wishes?
Preferences vary based on personal values, culture, and experiences.
When should ACP discussions ideally occur?
Early, before illness, and revisited throughout the illness trajectory.
What should nurses do after delivering difficult information?
Pause and explore emotions.
What is the purpose of the "Reframe" step in REMAP?
To explore the patient's perception of their situation.
What does asking about goals help determine?
What matters most to the patient in the time they have left.
What does acknowledging emotion during conversations achieve?
Helps patients feel heard and supported.
What is one topic patients should reflect on during ACP?
What is important to them or what makes life meaningful.
What are two goals of goals of care conversations?
Guide decisions and align treatments with patient values.
In SPIKES, what should be avoided when giving knowledge?
Medical jargon and vague wording.
Why explore a patient's "trade-offs"?
To understand how much intervention or suffering they're willing to tolerate.
Why is clarity important when discussing treatment options?
It ensures informed decision-making and reduces confusion.
Why revisit ACP at "transition points"?
Because goals and preferences may change with worsening symptoms or new diagnoses.
Why is prognosis shared gently and clearly?
To support understanding while minimizing distress and ensuring informed choices.
After completing REMAP or SPIKES, what is a key final step?
Summarize, recommend next steps, and confirm documentation.
Why are EOL conversations described as a "process"?
They require multiple discussions with ups and downs as the patient adapts.
What makes communication central to palliative care?
It guides goals, supports coping, and aligns care with what truly matters.