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Despite practice development in the area of advanced care planning (ACP) and systems wide changes implemented to support ACP processes, there has been a paucity of research which has addressed the experiences of a key stakeholder group – family and carers – as they navigate their way through these often very challenging processes. The study described in this article focussed on this key group.
Methods
In-depth qualitative interviews were undertaken with family members and carers in a regional area of Australia in order to illuminate their lived experiences of ACP processes.
Results
Thematic analysis of the narrative data yielded 4 key themes: Being overwhelmed on the ACP journey; unifying effects of completing and using an advanced care directive (ACD); experiencing the highlights and lowlights of care; and paying it forward in advice to staff, carers and families.
Significance of Results
The ACP journey is unique for each carer/family and can be overwhelming. Whilst he lived experiences of families/carers indicated that the quality of care received was of a high standard, feedback to staff suggested their communications be timelier and more empathic. All participants in this study reported benefitting from engaging in ACP early and appreciated support to do so. All benefitted from the preparation of an ACD and found the outcomes (in terms of concordance) gratifying.
The focus of this chapter is consent. Consent concerns the granting or withholding of permission to receive care. This chapter addresses the legal requirements of consent for adults and children, and looks at the place of guardianship and advocacy in decision-making. It also considers the situation of people who are not mentally competent who may require emergency care or who need to be restrained against their will. Consent is fundamental to the moral and professional principle that health care should be geared to the patient’s interests as the patient understands them. This is sometimes referred to as ‘patient-centred care’.
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