Barriers and Facilitators to Advance Care Planning (ACP) for People with Dementia Essay Sample, Ireland
The following essay sample work shall focus on the condition of dementia, palliative care or end-life care, patients, advance care planning barriers for people with dementia, and advance care planning (ACP) facilitators for people with dementia.
Dementia has become a global concern for the health of the general public as it has a very limited scope of care, diagnosis, and treatment. Almost 47.5 million people in the world have dementia condition and this number is growing rapidly.
Dementia is a series or range of all the progressive cognitive disorders such as Alzheimer’s disease, front temporal dementia, vascular dementia, dementia with Lewy bodies, etc. This condition can arise from many neurological disorders and medical conditions such as Parkinson’s disease.
Mostly the later adult groups get affected by this mental health condition and they need to be kept away in a care home or a setting within their own homes.
An Advance Care Planning (ACP) is a dynamic and continuous process of dialogue between an individual and his healthcare professionals which is in concern with future care and treatment including the end of life care.
ACP is important for patients with dementia when they lose their ability to make effective decisions in their lives.
Due to the progressive nature of the disease, advance care planning is always recommended for people who are in the early stages of dementia. General practitioners (GPs) are always responsible for initiating ACP for dementia patients.
There are many barriers and facilitators to advance care planning in people with dementia which will be discussed further in this essay.
Barriers to Advance Care Planning for Dementia Patients
There are certain barriers while making an advanced care plan for dementia patients and such planning is required as dementia is a highly progressive disease and can decline the cognitive ability of a person.
Some of the following barriers to advance care planning for the dementia patients are:-
Timely Initiation of ACP
People (mostly the older group) who are suffering from dementia are usually referred to the family carers and general practitioners who help in determining the right time for initiation of ACP.
There are certain health carers and family carers who are unaware of the future outcome of the disease so they remain in denial about the dementia diagnosis.
Unwillingness on the part of such GPs and carers to participate in ACP prevents them from discussing future preferences. Such uncertainty in the ACP initiative acts as a complete barrier to the ACP of dementia patients.
The other difficulty is the timing of ACP. Almost 40% of Irish GPs according to a survey agreed that ACP must be started at diagnosis while 46% strongly disagreed with this statement.
Since most older adults are the ones who are suffering from this condition so they refrain from making any plans and are less willing to engage in ACP. There is also a fear amongst the patients that initiating ACP would increase the anxiety of the family carers.
Engagement of Stakeholder
There is no proper and trust-based relationship between the family carers and stakeholders which hinders the ACP. Family carers believe that taking responsibility for ACP is very difficult as it is restricted by limited assessment of the people with dementia as they have poor decision-making capacity.
People with impaired cognitive abilities show more confidence in their decision-making in comparison to their family and relatives. Relatives can give better decisional preferences in comparison to others in such a condition.
Limited Conversation about ACP with Family Carers
The family carers of such a person with dementia disorder feel that they are less informed about the dementia condition, care, treatment, and its consequences.
Family members claim that they are unaware of the purpose of ACP and didn’t know about its existence. The family of such a person feels that the future care and preferences will not be met due to restrictions within the healthcare system.
GPs stated that when people with dementia and family members discussed their financial matters, power of attorney, and costs of settlement it was high. The preferences and willingness of the patient are not documented in the patient’s medical file or formal documentation.
Questioning the Feasibility and Credibility of ACP by Family Carers
The family carers and dementia patients have no faith in ACP because of the unpredictable nature of the disease and its progression.
They question the feasibility and credibility of ACP which does not allow them to discuss future care preferences. Preferences also change with time as the personality of the people changes with dementia and it might hamper the ACP.
Facilitators to Advance Care Planning for People with Dementia
The barriers discussed above if removed can become facilitators in the healthcare system to make advanced care planning for people with dementia. We shall discuss the facilitators in ACP for dementia patients.
Some of the following facilitators to advance care planning for people with dementia are:-
ACP Initiation on Time
People with dementia and family carers felt that early initiation to ACP after the diagnosis will ease the treatment and care of the people with dementia.
Cognitive decline is a major reason for the initiative of ACP at an early stage.
It helps in the facilitation of making correct assumptions about future care, preferences, diagnosis, and early admission into the hospital. An early start of ACP determines the social and medical aspects of ACP.
People with dementia and family carers state that ACP must take place with all stakeholders due to their effective decision-making process.
A good relationship between the family carers and patients of dementia facilitates the ACP and makes the discussion about ACP transparent.
People with dementia have claimed that when they lose their power of decision-making then they can easily rely upon their family members and carers for the decisions.
Such dementia patients with mild cognitive impairment have more confidence in making medical decisions on their own which makes them engage more in the ACP. It helps them to participate longer as they have confidence in their decision-making skills.
Discussion About ACP with Family Carers and Dementia Patients
When people with dementia and their family members are willing to have a normal discussion about the dementia condition that helps in achieving the goals of ACP.
Due to an open and transparent discussion about financial matters and power of attorney the family carers feel more responsible for knowing the future care and preferences of such a person with dementia.
People with dementia want to have their own social decisions which helps in the ACP. When the family carers are informed well about the severity of the dementia condition it facilitates the ACP.
Prerequisites of ACP
When sufficient knowledge about the dementia disease is passed on to the carers and GPs they need special skills and training to master the difficult subjects and for managing conflicts.
ACP consultation made the family carers more confident about their future wishes that will be catered to and respected. When GPs discuss positive outcomes of ACP for dementia patients then it facilitates ACP for more such patients suffering from the same condition.
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The above-written essay sample is written to highlight the barriers and facilitators to advance care planning for people with dementia.
Psychology QQI Level 5, Nursing QQI Level 5, Care of the Older Person QQI Level 5, Gerontology QQI Level 6, Dementia Care and Awareness Course, Careskills QQI Level 5 and Wellbeing QQI Level 5 students can read this sample to benefit from it by gaining knowledge on such topics related to psychology.
We have many psychology-based assignments available online on our official website. Some of them are Parkinson’s Chronic Disease for Older Care, Cognitive Psychology, Alzheimer’s Disease Older Person Care, and National Dementia Strategy in Ireland.
You can hire an online essay writer for writing essays. We can provide you with essay writing help for care skills, care of the older person, and dementia assignments. Ireland assignment help website can assist in writing assignments.
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