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<title>Advance Care Planning (ACP) | EnRICH</title>
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<body>
<header>
<div class="header-content">
<a href="index.html" class="logo-section">
<img src="EnRICH_Logo_solid.png" alt="EnRICH Logo">
<div class="logo-text"><h1>EnRICH</h1><p>Enhanced Reviews in Care Homes</p></div>
</a>
<nav>
<a href="index.html">Home</a>
<a href="about.html">About EnRICH</a>
<a href="services.html" class="active">Our Services</a>
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<div class="nhs-banner"><span class="banner-text">A service provided by <strong>Cambridge University Hospitals NHS Foundation Trust</strong> & <strong>Cambridgeshire & Peterborough NHS Foundation Trust</strong></span></div>
<main>
<a href="services.html" class="back-link">← Back to Our Services</a>
<div class="page-title">
<h2>Advance Care Planning (ACP)</h2>
<p>Supporting people to share their wishes for future care</p>
</div>
<div class="content-card">
<h3>What is Advance Care Planning?</h3>
<div class="definition-box">
"Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their wishes."
<cite>— International Consensus Definition of Advance Care Planning</cite>
</div>
<p>Effective advance care planning (ACP) is <strong>practical and fluid</strong> to accommodate and anticipate a person's future. It's not just about end of life - it's an opportunity to explore values, beliefs and preferences relating to daily life, right through to anticipated situations where a person may wish to specify the limits of treatments intended to sustain life.</p>
<div class="important-note">
<p><strong>Important:</strong> ACP is not just about the end of life. To be most effective and helpful, the process needs to begin as early as possible and develop as it is reviewed, refined and focused by how a person's health changes over time.</p>
</div>
</div>
<div class="content-card">
<h3>Why Advance Care Planning Matters</h3>
<p>Early discussion with a patient and their family as health changes restores personhood as it explores someone's physical, psychological, social, spiritual and cultural self. ACP helps ensure:</p>
<ul class="key-points">
<li>People receive care that aligns with their values and wishes</li>
<li>Families understand what their loved one would want</li>
<li>Healthcare teams can make informed decisions during emergencies</li>
<li>Unnecessary and unwanted treatments are avoided</li>
<li>A sense of control and self-determination is maintained</li>
</ul>
</div>
<div class="content-card">
<h3>When to Start ACP Conversations</h3>
<p>Triggers to start ACP include a change in health or personal circumstances. Good times to have these conversations include:</p>
<div class="outcomes-grid">
<div class="outcome-card">
<h4>Change in Health</h4>
<p>After an illness, fall, or hospital admission</p>
</div>
<div class="outcome-card">
<h4>New Diagnosis</h4>
<p>When a significant condition is identified</p>
</div>
<div class="outcome-card">
<h4>Life Changes</h4>
<p>Moving into care, loss of a spouse</p>
</div>
<div class="outcome-card">
<h4>Routine Reviews</h4>
<p>As part of regular health assessments</p>
</div>
</div>
<p style="margin-top: 1rem;">Starting this conversation is important as it <strong>restores a sense of control and self-determination</strong> when a person may feel disempowered by events. Being honest and open builds the trust that facilitates these conversations.</p>
</div>
<div class="content-card">
<h3>Having the Conversation</h3>
<div class="conversation-tips">
<h4>Tips for ACP Conversations</h4>
<ul>
<li>Start with affirming a commitment to helping the person fulfill their goals and live well</li>
<li>Ask who they would like to support them with the process</li>
<li>Encourage them to involve family and carers - it's difficult to ensure wishes are followed if those caring aren't aware of them</li>
<li>Ask open questions that enable the person to talk about what matters most to them</li>
<li>Talk about treatment options - start with what can be done to help improve quality of life</li>
<li>Be vigilant for indicators (verbal and non-verbal) that the person wants to end the conversation</li>
<li>Don't force the pace - offer to stop and come back another day</li>
<li>Good care planning needs several conversations and regular review</li>
</ul>
</div>
</div>
<div class="content-card">
<h3>Possible Outcomes of ACP</h3>
<p>The outcome of an advance care planning conversation may be:</p>
<div class="outcomes-grid">
<div class="outcome-card">
<h4>Nothing Formal</h4>
<p>Simply having the conversation can be valuable</p>
</div>
<div class="outcome-card">
<h4>ADRT</h4>
<p>Advance Decision to Refuse Treatment (Living Will)</p>
</div>
<div class="outcome-card">
<h4>LPA</h4>
<p>Lasting Power of Attorney for health decisions</p>
</div>
<div class="outcome-card">
<h4>Formal ACP</h4>
<p>Documented plan like ReSPECT</p>
</div>
</div>
</div>
<div class="respect-box">
<h4>ReSPECT - Recommended Summary Plan for Emergency Care and Treatment</h4>
<p>ReSPECT is a process that creates personalised recommendations for a person's clinical care and treatment in a future emergency when they may lack capacity to make or express choices. It provides a clear, accessible record of recommendations that all healthcare professionals can refer to.</p>
<p style="margin-top: 0.75rem;">The EnRICH team uses ReSPECT forms as part of our advance care planning process, ensuring that residents' wishes are clearly documented and accessible across care settings.</p>
</div>
<div class="enrich-note">
<h4>ACP in EnRICH</h4>
<p>Through the EnRICH service, our specialist geriatricians provide systematic advance care planning for care home residents. This includes ReSPECT form completion, family discussions about goals of care, end-of-life care planning, clear ambulance guidance, and documentation of treatment preferences. We work closely with residents, families, and care home staff to ensure wishes are understood and respected.</p>
</div>
<div class="bgs-attribution">
<h4>Learn More from the British Geriatrics Society</h4>
<p>This information is based on the BGS End of Life Care in Frailty guidance series.</p>
<a href="https://www.bgs.org.uk/resources/end-of-life-care-in-frailty-advance-care-planning" target="_blank" rel="noopener noreferrer">Visit BGS ACP Guidance →</a>
</div>
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