advance care planning: what it means and how to do it · 2019-12-17 · booklet understanding...

Advance Care Planning: What it means and how to do it

Module

3

Booklet

Advance Care Planning: What it means and how to do it

Module 3

Objectives At the end of this module, participants will have:

l Reflected on module two

l Gained understanding and knowledge of the definition and components of ‘advance care planning’ in the context of the Mental Capacity Act of 2005

l Explored their own perspectives on ‘advance care planning’, including what they would wish others to know about them as individuals if they became volunteer educators

l Explored issues of diversity and culture in advance care planning

l Had opportunities to examine and express a range of views and opinions about advance care planning and access an overview of evidence from research into the process and outcomes of ‘advance care planning’

l Examined a range of information resources about ‘advance care planning’ and considered how to use them in awareness raising activities among different audiences.

Any part of this publication can be copied, reproduced, distributed or adapted without permission from the authors provided that the recipient of the materials does not copy, reproduce, distribute or adapt it for commercial gain. The following wording should be used to credit the source of the information in all of the copies, reproductions, distributions and adaptations of the material.

“Based on work from the Volunteer Training Programme about Advance Care Planning (Let’s Talk Now and Prepare for the Future) developed by Jane Seymour, Kathryn Almack (University of Nottingham) and Katherine Froggatt (Lancaster University), supported and funded by the National End of Life Care Programme and the Dying Matters Coalition”

1

Sect

ions

Tim

e ne

eded

Cont

ent

Act

ivit

yRe

sour

ces

requ

ired

Out

com

e

1In

trod

uctio

ns

and

prac

tical

in

form

atio

n

10 m

inut

esW

elco

me

and

brie

f ho

usek

eepi

ng

pres

enta

tion;

tim

etab

le

and

obje

ctiv

es fo

r M

odul

e 3

Pres

enta

tion

by fa

cilit

ator

sH

ando

ut w

ith o

bjec

tives

fo

r Mod

ule

3Pa

rtic

ipan

ts fe

el w

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me

and

com

fort

able

; int

rodu

ced

to th

e tim

etab

le a

nd o

bjec

tives

of t

he

mod

ule;

pro

vide

d w

ith h

ealth

and

sa

fety

info

rmat

ion

2 Re

flect

ions

on

mod

ule

2

15 m

inut

esPa

rtic

ipan

ts h

ave

an

oppo

rtun

ity to

sha

re th

eir

thou

ghts

and

refle

ctio

ns

abou

t pee

r edu

catio

n fr

om

Mod

ule

2

Who

le g

roup

di

scus

sion

Flip

cha

rt, p

enci

ls a

nd

note

pap

erPa

rtic

ipan

ts id

entif

y an

d sh

are

wha

t ke

y le

arni

ng p

oint

s th

ey g

aine

d fr

om M

odul

e 2

3 U

nder

stan

ding

ad

vanc

e ca

re

plan

ning

: an

intr

oduc

tion

45 m

inut

esPa

rtic

ipan

ts h

ave

an

oppo

rtun

ity to

gai

n kn

owle

dge

of th

e m

eani

ng

and

com

pone

nts

of

adva

nce

care

pla

nnin

g, in

th

e co

ntex

t of U

K la

w a

nd

polic

y

Pres

enta

tion

by fa

cilit

ator

, fo

llow

ed b

y op

port

uniti

es

for d

iscu

ssio

n an

d qu

estio

ns

Pow

erPo

int S

lides

- Se

ctio

n 3,

sh

eets

of A

4 pa

per,

flip

char

t and

pen

s

Part

icip

ants

und

erst

and

the

mea

ning

of a

dvan

ce c

are

plan

ning

an

d its

com

pone

nts,

in th

e co

ntex

t of

con

tem

pora

ry p

olic

y an

d th

e pr

ovis

ions

of t

he M

enta

l Cap

acity

Ac

t (20

05)

4 Ex

plor

ing

adva

nce

care

pl

anni

ng: o

ne

size

doe

sn’t

fit a

ll

1 ho

ur a

nd 2

0 m

inut

esPa

rtic

ipan

ts e

xplo

re th

eir

own

pers

pect

ives

on

adva

nce

care

pla

nnin

g,

in th

e co

ntex

t of t

heir

pers

onal

mea

ning

s an

d id

entit

ies.

Part

icip

ants

co

nsid

er ‘d

iffer

ence

’ in

adva

nce

care

pla

nnin

g,

and

cultu

ral a

nd s

ocia

l in

fluen

ces

on th

is

Part

icip

ator

y ex

erci

ses,

paire

d di

scus

sion

, w

hole

gro

up

feed

back

Ask

par

ticip

ants

to

brin

g so

met

hing

to th

is

sect

ion

that

is im

port

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to th

em a

nd re

flect

s th

eir i

dent

ity. F

lip c

hart

pa

per a

nd p

ens.

Som

e m

eans

of fi

xing

flip

cha

rt

pape

r in

a de

sign

ated

di

spla

y ar

ea, A

4 pa

per

and

pens

Part

icip

ants

gai

n in

sigh

t int

o th

eir

own

attit

udes

tow

ards

adv

ance

ca

re p

lann

ing

and

thei

r sel

f ide

ntity

an

d de

velo

p aw

aren

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of d

iffer

ent

pers

pect

ives

. Par

ticip

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me

expe

rienc

e of

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ticip

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g in

a d

iscu

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n ab

out a

dvan

ce

care

pla

nnin

g an

d re

cord

ing

of

appr

opria

te in

form

atio

n

You’ll need to factor in time for breaks. We’ve suggested a time, but you’ll need to be guided by the group.

Booklet

Suggested Timetable - approximately 4 hours + break

Advance Care Planning:What it means and how to do itModule 3

2

Brea

k

Sect

ions

Tim

e ne

eded

Cont

ent

Act

ivit

yRe

sour

ces

requ

ired

Out

com

e

5 Ev

alua

ting

adva

nce

care

pla

nnin

g:

deba

tes

and

dile

mm

as

30 m

inut

esPa

rtic

ipan

ts a

re

intr

oduc

ed to

a ra

nge

of

rese

arch

evi

denc

e ab

out

adva

nce

care

pla

nnin

g

Shor

t pre

sent

atio

n fo

llow

ed b

y w

hole

gr

oup

disc

ussi

on

Pow

erPo

int S

lides

- Se

ctio

n 5,

flip

cha

rt

and

pens

Part

icip

ants

gai

n in

sigh

t int

o so

me

of

the

rese

arch

rela

ting

to a

dvan

ce c

are

plan

ning

and

dis

cuss

an

d id

entif

y ‘ga

ps’ a

s in

ev

iden

ce. P

artic

ipan

ts

deve

lop

awar

enes

s of

th

e ro

le o

f res

earc

h in

dev

elop

men

t of

prac

tice

in a

dvan

ce c

are

plan

ning

.

6 W

orki

ng w

ith

adva

nce

care

pl

anni

ng re

sour

ces:

w

hat,

whe

n, h

ow?

1 ho

urPa

rtic

ipan

ts e

xam

ine

the

info

rmat

ion

reso

urce

pa

ck fo

r adv

ance

car

e pl

anni

ng a

nd c

onsi

der

how

they

mig

ht u

se th

e m

ater

ials

in d

iffer

ent

cont

exts

.

‘Tab

le to

p’ p

artic

ipat

ory

exer

cise

Copi

es o

f the

reso

urce

pa

ck (a

vaila

ble

in

appe

ndic

es),

A4

pape

r, fli

p ch

art

and

pens

Part

icip

ants

gai

n fa

mili

arity

with

a ra

nge

of re

sour

ces

to s

uppo

rt

volu

ntee

r edu

catio

n in

ad

vanc

e ca

re p

lann

ing

and

cons

ider

how

to u

se

them

in p

ract

ice.

7 Re

cap,

eva

luat

ion

and

refle

ctio

n

15 m

inut

esPa

rtic

ipan

ts re

cap

and

eval

uate

Mod

ule

3 an

d re

ceiv

e in

form

atio

n ab

out M

odul

e 4

Com

plet

ion

of

eval

uatio

n fo

rms;

Pr

ovis

ion

of in

form

atio

n fo

r Mod

ule

4

Pow

erPo

int S

lide

1 - S

ectio

n 7,

eva

luat

ion

form

(ava

ilabl

e in

ap

pend

ices

), po

st it

not

es a

nd p

ens,

info

rmat

ion

for

Mod

ule

4

Part

icip

ants

hav

e an

op

port

unity

to p

rovi

de

feed

back

on

Mod

ule

3 an

d re

ceiv

e ne

cess

ary

info

rmat

ion

abou

t the

ne

xt m

odul

e

Booklet

Suggested Timetable - approximately 4 hours + break

You’ll need to factor in time for breaks. We’ve suggested a time, but you’ll need to be guided by the group.


3

Booklet

Introductions and practical informationSection

1


l Welcome the participants to Module 3

l Introduce them to their facilitators

l Provide them with information about health/safety (fire procedures and exits; location of toilets; breaks and lunch; special needs)

l Check to see if any arrangements need to be made in relation to transport and explain arrangements for expense reimbursement.

Short introductory presentation and welcome

Time: 10 minutes

Materials Handout with objectives for Module 3

Purpose

Participants are made to feel welcome and comfortable

Participants are introduced to the facilitators and provided with health and safety information

Special needs (e.g. hearing loss) and any necessary transport arrangements are identified

Arrangements for claiming expenses are explained

Notes

4

Booklet

Reflections on Module 2Section

2


Activity

Time: 15 minutes

Materials Flip chart, pencils and note paper

Purpose

Participants examine and share what key learning points they gained from Module 2

Facilitator gains insight into areas of educational needs/or issues of understanding among participants, which can be subsequently addressed

Ask if the group feels comfortable discussing their reflections on Module 2 as a whole group. If preferable, this can be done in pairs. Remember that some people may not respond because they feel vulnerable.

l Suggest that participants spend a few minutes jotting down immediate response to three ‘key’ questions:

l What did you most enjoy from Module 2?

l What did you least enjoy?

l What was the most important thing that you learnt about peer education from Module 2?

Facilitate a discussion around these questions by asking participants to offer their thoughts, once they have had a few minutes to reflect individually. Get your co-facilitator to record information on a flip chart, so that this can be written up and distributed in summary form to participants later (if you have the facilities to do so).

You might want to have a break at this point.

5

Activity and presentation

Time: 45 minutes Materials PowerPoint Slides - Section 3, sheets of A4 paper, flip chart and pens

Purpose

Participants understand the meaning of advance care planning and its components, in the context of contemporary policy and the provisions of the Mental Capacity Act (2005)

Booklet

Understanding advance care planning: an introductionSection

3


You will need to be familiar with ‘Advance care planning: a guide for health and social care professionals’ published by the National End of Life Care Programme to facilitate this module. (note: to be replaced shortly by third edition of this document). You can download it from: www.endoflifecareforadults.nhs.uk

Note for facilitators

l Break this section into three parts: preliminary exploration (10-15 minutes); provision of information (20 minutes); checking and questioning (10-15 minutes)

l Begin by explaining to participants that this section provides a broad overview of the meaning of ‘advance care planning’ and should enable them to understand its various components

l Then ask for people’s current understandings of the term and whether they have had any experience of advance care planning. Write down contributions on a flip chart

l Explain that the section will raise questions for the participants and advise them to jot down questions as they arise, using the paper and pens provided

l Mention that they may have heard other terms that relate to advance care planning, such as preferred priorities of care or ‘end of life care planning’

l Use the PowerPoint Slides - Section 3 to provide a brief overview of advance care planning (with due reference to the guide referred to above)

l Make sure some time is left to address questions and to check any areas of misunderstanding.

6

Booklet

Exploring advance care planning: one size doesn’t fit allSection

4


Activities

Time: 1 hour 20 minutes

Materials In advance, ask participants to bring something to this section that is important to them and reflects their identity. Flip chart paper and pens. Some means of fixing flip chart paper in a designated display area, A4 paper and pens.

There are 3 parts to this section: 1. Who am I? (30 minutes)2. What would people need to know about me? (45 minutes)3. We are all different (5 minutes)

1. Who am I? The purpose of this exercise is to get participants to think about their own identity and to experience sharing something that is important to them with another person.

l Ask the participants to work in pairs for this exercise and say that you will be asking them to also share with the whole group

l Ask participants to then write down what the object means to them and why it reflects their identity, and to share this information with their partner. If people are happy to do so, invite them to share this information with the rest of the group

l With people’s permission, display the flip chart accounts in the display area and allow a few minutes for people to look at these if they wish.

NotesSection 4 continued

7

Purpose

Booklet

Exploring advance care planning: one size doesn’t fit allSection

4


2. What would people need to know about me? (45 minutes) The purpose of this exercise is to enable participants to imagine participating in a discussion about advance care planning, and to help them to think about the relevance of ACP in a personal sense. The whole group feedback will allow them to appreciate differences in one small group.

l Ask the participants to return to work in their pairs. Ask them to imagine that the other person is someone who cares for them (either a health or social care worker or a relative) and to talk to this person about their needs and wishes in the event of illness and incapacity. Ask the partners to write down a summary of the discussion and then to check out what they have written with the other person

l Give participants some ideas about the sorts of things that they may wish to discuss, if necessary, but try not to be too directive

l Ask each pair to take turns in playing the role of A) someone talking about their needs and wishes in the event of illness of incapacity and B) either a health or social care worker or a relative/friend of person A

l An important aspect of this exercise is to see how easy or difficult participants find it to accurately record their partner’s needs and preferences and how comfortable it was to engage in the discussions. Focus on these issues in a whole group feedback section.

3. We are all different (5 minutes)As part of the whole group feedback from part 2 of this section, highlight the differences between individuals with regard to their preferences and wishes and say a few words about the likelihood that there is a range of perspectives on advance care planning across cultures and societies.

Participants gain insight into their own attitudes towards advance care planning and their self identity and develop awareness of different perspectives

Participants gain some experience of participating in a discussion about advance care planning and recording of appropriate information

Continued

8

Purpose

Participants gain insight into some of the research relating to advance care planning and discuss and identify ‘gaps’ in the evidence available

Participants develop awareness of the role of research in development of practice in advance care planning

Booklet

Evaluating advance care planning: debates and dilemmasSection

5


Activity and presentation

Time: 30 minutes

Materials PowerPoint Slides - Section 5, flip chart and pens

l Explain to participants that this short section is to examine some research evidence about advance care planning

l Ask the group for their views on what evidence might be important in relation to advance care planning and write down their ideas on a flip chart (prompt them to think about issues such as: the impact on people that take part in advance care planning; factors that might i) assist or ii) stop people taking part in advance care planning; the influence of advance care planning on care provided towards the end of life; attitudes to advance care planning)

l Go through PowerPoint Slides - Section 5 which is a brief summary of some evidence from research. Get the group to identify any ‘gaps’ in the research and to discuss how practice in advance care planning might be informed by research.

Notes

9

Activity

Time: 1 hour

Materials Copies of the resource pack (available in appendices), A4 paper, flip chart and pens

Purpose

Participants gain familiarity with a range of resources to support volunteer education in advance care planning and consider how to use them in practice

Booklet

Working with advance care planning resources: what, when, how?Section

6


l This activity involves enabling participants to consider the potential use and their preferences about the various resources in the resource pack

l Depending on the size of the group, this could either be done in pairs, or using a ‘table top’ style activity, which involves displaying different components of the pack on tables and moving small groups round to each table in turn

l Ask the small groups or pairs to examine the resources and to discuss which are best suited for particular sorts of awareness raising activities and which they would feel most comfortable using

l Ask them to write some notes down about their views

l Facilitate a whole group discussion and note some ideas about use of the materials on the flip chart (if you have the facilities, these can then be distributed to the whole group at a later time).

Notes

10

Activity

Time: 30 minutes

Materials PowerPoint Slide - Section 7, evaluation forms (available in appendices), post it notes and pens

Purpose

Participants examine and share what key learning points they gained from Module 3

Facilitator gains insight into areas of educational needs/or issues of understanding among volunteers, which can be subsequently addressed

l Briefly recap on what has been covered in this module

l Ask participants to work in pairs and to discuss: 1) what they most and least enjoyed about the module; 2) what two or three key things they have learnt; 3) what needs for further information they have

l Ask them to write these down on post it notes (they don’t have to add their names unless they want to)

l Make it clear that these will help the facilitator team pick up on issues and problems next time

l Ask participants to complete evaluation form.

Brief provision of information

l Give information about Module 4, and talk through practical arrangements as required

l Thank everyone for their participation and hard work

l Make sure that they have contact details for on-going contact.

Booklet

Recap, evaluation and reflection Section

7


11

Notes

12

advance care planning: what it means and how to do it · 2019-12-17 · booklet understanding...

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