2.2 - Terminology
Advance Care Planning: Planning as early as possible for any patient healthy or not. It is stating one's wishes and preferences for future care in the event of an acute medical crisis or sudden health deterioration. An advance care plan may be used to guide the substitute decision maker and the healthcare team about what an patient would want or not want if they were unable to speak for themselves.
Examples: Can include Representation Agreements and Advance Directives as well as informal conversations with family and friends. It is beneficial to do this in advance of a serious illness.
Adapted from: BC Ministry of Health, Advance Care Planning, Making Future Health Care Decisions.
Serious Illness Conversations: A conversation with a patient who has a serious illness or life-limiting condition to explore their values, wishes and beliefs. This conversation framework is based upon two key principles: personhood and dignity, and is focused on learning who the person is and what matters most to them, while sharing the team's insight as to how the patient's condition may progress. Information from this conversation can be used to determine goals of care and treatment options that align with a patient's unique needs and wishes.
Example: "I want to spend more time at home with my family as my illness progresses." And "I am most worried about how my husband will manage as a single parent."
"Goals of Care" refers both to the overall intent of medical treatment (along a spectrum from cure at all costs, through life prolongation to a focus on maximizing comfort) and to more specific goals as defined by the client's values and priorities at a given point in time (e.g. improving or maintaining mobility, spending as much time as possible with family...). The goals of care guide specific medical decisions. A client's goals of care can change over time. A client's Advance Care Plan (ACP) can inform the goals of care and similarly a conversation about goals of care can lead to updates on the ACP.
"I'm willing to have fluid drained from my abdomen to help improve my breathing, but I would like to have it done without being admitted to the hospital."
Adapted from: Canadian Hospice Palliative Care Association, The way forward national framework: A roadmap for an integrated palliative approach to care.
