Courageous Conversations: Advance Care Planning with Teens with Serious Medical Conditions and their Families. Issue 2 (1st June 2012)

• Record Type: Journal Article
• Authors: Lyons, M; Briggs, L
• Is Part Of: BMJ supportive & palliative care. Volume 2:Issue 2(2012)
• Page Start: 187
• Page End: 187
• Publication Date: 2012-06-01
• Subjects: Palliative treatment -- Periodicals; Terminal care -- Periodicals; 616.029
• DOI: 10.1136/bmjspcare-2012-000250.64
• Languages: English
• ISSNs: 2045-435X

Abstract

Abstract : Advance care planning (ACP) is not a "one size fits all" conversation. The Respecting Choices Disease Specific ACP (DSACP) intervention is an in-depth planning process for patients with serious medical conditions and their families. Delivered by trained facilitators in the outpatient setting, patients are assisted to clarify their goals for care in "bad" outcomes situations. In adult populations, this intervention increases understanding of treatment decisions between patients and their chosen surrogates and is a highly satisfying discussion. The DSACP intervention has been applied to HIV+ adolescents through the FAmily-CEntered (FACE) Advance Care Planning (ACP) intervention. In a randomized controlled clinical trial FACE dyads received: (1) Lyon Advance Care Planning Survey©; (2) Respecting Choices DSACP interview®; (3) Five Wishes©. FACE adolescents felt significantly better informed about end-of-life decisions than controls; had a higher congruence on every situation; rated the overall quality of discussion as very good to excellent; were more likely to rate sessions positively, and complete advance directives. There was no increase in anxiety scores post intervention. This application is continuing through an ongoing RCT with HIV+ adolescents as well as teens with cancer. Evidence supports the application of a facilitated ACP process for adolescents with HIV/AIDS and cancer and their families.