Communication about end of life care may involve difficult
conversations for patients, family members and health
professionals. However, a lack of understanding of a
person’s wishes about their future care may result in a loss
of dignity for the person, and additional distress for their
family members and health professionals and burden to the
This article discusses the barriers to advance care planning
and provides some guidance for the general practitioner
in undertaking advance care planning with patients and
their families. Tips for initiating end of life discussions with
patients and families utilising the ‘PREPARED’ acronym,
and ensuring appropriate care delivery are included.
Involving patients and their family members in advance
care planning may be challenging and time consuming for
GPs. However, there are a number of resources to support
this activity in relation to training, communication support
and Medicare item funding.
Issues surrounding end of life (EOL) decision making, continue to be topical and widely debated. Many people do not wish to think or talk about their death or dying until it is too late. This can have serious repercussions on a number of fronts. Resources may be utilised to provide patients with treatments they do not want, distress may be experienced by family members and considerable stress placed on staff, as well as creating difficulties in areas such as organ donation. With organ donation rates in Australia being one of the lowest in the world, this latter point needs also to be considered. Lack of knowledge and poor communication between patients, family members and health professionals may contribute to family trauma.1
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