Choice Case Studies Database

Since June 2006, I have been involved in a pilot project with 5 care homes in South Leeds, implementing the Gold Standards Framework in Palliative and Supportive Care.

Implementation has been delivered in ‘bite sized’ pieces, one of the most recent developments being the introduction of an Advanced Care Plan and although not a legal document, is a tool that encourages residents and families to ‘think ahead’, explore which elements of care are important to them, what they do and don’t want to happen and who they would like to be involved. The tool also helps to address discussions on those extremely sensitive issues of Preferred Place of Care and resuscitation status.

Recently, a hospital admission was averted when the local GP became aware that the resident had expressed a wish on his Advanced Care Plan, to be cared for in the care home. Documentation on resuscitation status poses difficulties, the majority of residents expressing a wish not to be resuscitated, others wanting to be resuscitated but not to be admitted to hospital, which lends itself to contradiction and ultimately misunderstanding from both resident and family. The tool therefore allows further discussions to take place between care home staff and service users, in order to provide clarity and a clearer understanding of choice in crucial end of life issues.