One of the few certainties in life is the inevitability of death. Despite this, many people do not prepare for their own death and do not discuss their priorities or preferences for care as they approach the end of their lives, either with their families or with health and social care professionals. Professionals who care for people who are approaching the end of life may sometimes fail to recognize this or may lack the skills to initiate discussions with their patients about their priorities and preferences. Professionals may fear that raising such matters will cause distress. They may not appreciate that, if done well, discussions can enable patients and their families to prepare and can address fears and relieve anxiety. Discussion and planning can provide a patient with a much greater chance of dying in the place of their choice, with their preferences for care being respected.
The editors of Advance Care Planning in End of Life Care have brought together the insight and perspectives of a large number of leading experts in this field from the UK, Australia, Canada, and the USA. These include physicians, nurses, academics, health service managers, and those working for patient associations and charities. Importantly the authors include people working in hospitals, the community, care homes and hospices, and those caring for both young and older people. Each chapter is thoroughly referenced.
Interestingly, what emerges from the different contributors is a growing consensus about the benefits of having sensitive discussions with patients about their wishes for future care and recording patients' preferences. Most importantly the book provides excellent examples about how this can and has been achieved in a variety of settings.
The End of Life Care Strategy in England recognizes identification of people who are approaching the end of life and initiating discussions as the first step of an end of life care pathway. The strategy recognizes that lack of open discussion is one of the key barriers to the delivery of good end of life care.
I thoroughly recommend this book as a key resource to improve care at the end of life. I believe that many individual professionals will find it useful in their clinical practice.
Professor Sir Mike Richards, CBE, MD, FRCP
National Clinical Director for Cancer and End of Life Care
Department of Health