Lionel’s family was devastated when they learned that their father had been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), a progressive chronic inflammatory lung disease that worsens over time.
Referred to St Luke’s Community Clinic (SLCC) for long-term chronic disease management, Lionel’s father was cared for by a multi-disciplinary team. His family physician recommended him to start Advance Care Planning (ACP), which is particularly important for people who have chronic illnesses, early cognitive impairment, frailty or approaching end of life.
ACP is a national programme that helps communicate a patient’s values and healthcare preferences to their loved ones and healthcare team. This helps to make decision-making less stressful for families, plan for end-of-life care and improve the patient’s quality of life. Anyone can start their ACP regardless of their age or health condition.
Over four months, ACP facilitator Shahryanty conducted a series of Tele-ACP sessions, carefully guiding Lionel’s family through the process. Under her guidance, Lionel engaged his father in meaningful discussions about legacy building and last rites planning, ensuring his father’s understanding and consensus.
The ACP was completed successfully, clearly documenting his father’s medical preferences, such as limiting resuscitation and avoiding intubation.
When Lionel’s father’s health deteriorated, he was readmitted to the hospital. A family conflict arose when Lionel’s mother insisted on resuscitation against his father’s wishes, underscoring the emotional complexities of end-of-life decisions.
The medical team referenced the ACP documents, honouring the patient’s preferences and care decisions.
“ACP is essential for planning future healthcare decisions. It involves discussions about personal beliefs and goals of care with loved ones and healthcare providers, ensuring individuals’ preferences are respected, even in difficult circumstances,” said Shahryanty, ACP facilitator in SLH.
Reflecting on the process, Lionel acknowledged the impact of ACP, which facilitated crucial conversations and educated the family on end-of-life matters. “ACP not only guided medical decisions but also provided emotional closure and facilitated legacy planning. Shahryanty has been instrumental in this process, helping my family navigate our father’s final days with clarity and purpose”.
