• Alison Rich Weston-super-Mare
  • Julian Abel Weston-super-Mare



Advance care Planning, end-of-life planning, mental capacity


Talking to patients about dying is never easy, so anything that can improve this communication has to be a significant benefit. Recent national developments in the UK have highlighted the importance of choice for patients in both the place they die, and the interventions they would want to have. Such developments are aimed at improving quality of care and empowering patients and include the national NHS End of Life Care Programme (2009) and The Mental Capacity Act (2005). This article examines the evidence behind using Advance Care Planning (ACP) as well as the practical issues of who might be best placed to undertake these discussions and what documentation tools to use. It concludes that care should be individualised and full use made of established professional relationships. Communication needs to be to the highest standard as the risks of causing distress are significant. Full use of the breadth of the multi-disciplinary team can enable full discussion of wishes around spiritual, social as well as medical care.

Author Biography

  • Julian Abel, Weston-super-Mare

    Alison Rich and Julian Abel are consultants in Palliative Medicine in Weston-super-Mare. They care for patients in the hospital, hospice and community settings. They have a particular interest in enabling patients to be engaged in planning care and in the process of effectively sharing this information.


BARNES K, JONES L, TOOKMAN A, KING M 2007 Acceptability of an advance care planning interview schedule: a focus group study. Palliative Medicine 21 p23-28.

BLACKFORD J, STRICKLAND E, MORROS B, 2007 Advance care planning in residential aged care facilities. Contemporary Nurse: a Journal for the Australian Nursing Profession 27(1) p141-152.

CAPLAN G A, MELLER A, SQUIRES B, CHAN S, WILLETT W 2006 Advance care planning and hospital in the nursing home. Age and Ageing 25 p581-585.

DAVISON S N, TORGUNRUD C 2007 The creation of an advance care planning process for patients with ESRD. American Journal of Kidney Disease 49 (1) p27-36.

DAVISON S N, SIMPSON C 2006 Hope and advance care planning in patients with end stage renal disease: Qualitative interview study. British Medical Journal 333 p886-890.

Gold Standards Framework(2009) _GSF/TheEssentialsofGSF.htm

HORNES G, SEYMOUR J, SHEPHERD K 2006 Advance care planning for patients with inoperable lung cancer. International Journal of Palliative Nursing 12(4) p172-178.

JACOBSEN J 2000 Advance medical directives. Nursing Case Management 5(1) p26-31.

NHS (2009) End of Life Care (EoLC)

Mental Capacity Act 2005

PARKMANN C A, CALFEE B E 1997 Advance Directives: Honouring your patient’s end of life wishes. Nursing TImes April p48-53

PAUTEX S, HERRMANN F R, ZULIAN G B 2008 Role of advance directives in palliative care units: a prospective study. Palliative Medicine 22 p835-841.

Respecting Patient Choices (2007)

Royal College of Physicians. 2009 Advance Care Planning. Concise Guide to Good Practice. No 12.

SAMPSON E L 2008 Palliative care in advanced dementia; a mixed methods approach for the development of a complex intervention. BMC Palliat Care 7 p8.

SEAL M 2007 Patient Advocacy and Advance Care Planning in the Acute Hospital Setting. Australian Journal of Advanced Nursing 24(4) p29-37.

SHANLEY C, WALL S 2004 Promoting Patient Autonomy and Communication through advance care planning: a challenge for nurses in Australia. Australian Journal of Advanced Nursing 21(3) p3239.

SCHIFF R, SHAW R, RAJA N, RAJKUMAR C, BULPITT C J 2009 Advance end-of-life healthcare planning in an acute NHS hospital setting;development and evaluation of the expression of healthcare preferences (EHP) document. Age and Ageing 38(1) p81-85.

SIMON J, MURRAY A 2008 Facilitated Advance Care Planning : What is the Patient Experience? Journal of Palliative Care 24(4) p256-264.

Weston Hospice (2008) advance_planning



How to Cite

Rich, A., & Abel, J. (2013). ADVANCE CARE PLANNING: HOW DOES IT WORK IN PRACTICE?. Health and Social Care Chaplaincy, 12(2), 47-51.