Advance care planning is important for everyone – but even more so for the elderly, a growing population in Canada. Researchers in southeastern Ontario are developing a program of online educational training and resources for health care providers with elderly patients in primary and long-term care settings, with the goal of better understanding how to facilitate these important conversations.
Dr. John Puxty, a geriatrician and the Director of the Centre for Studies in Aging and Health in Kingston, Ontario, is piloting the blended e-learning program, which targets physicians, health professionals and unregulated staff in southeastern Ontario. The program is delivered through a variety of venues including facilitated workshops, webinars and self-paced e-learning modules. It includes important information about ACP, as well as current legislation and health care consent, and gives participants the opportunity to work through various scenarios and plans for approaching these conversations. Speak Up Ontario resources are included as part of the resources offered.
“One activity that we’ve found very useful is to have our participants actually do their own advance care planning as part of the program,” says Dr. Puxty. “It really helps them get a sense of how the discussion feels from the patient/family side.” His team follows up with participants to get feedback on the program and resources, and will evaluate whether it has influenced their practice. Over the next nine months, the team will be rolling out the program and resources throughout southeastern Ontario, and also introducing it into the Family Medicine resident program at Queen’s University.
As a geriatrician, Dr. Puxty notes that these are critical discussions for the elderly, particularly those who are frail with multiple chronic diseases, especially memory disorders, or are in the process of care transitions. “We are seeing patients who are living longer with these conditions, including dementia, and with more opportunities for medical treatments,” he says. “It’s vital that we learn how to best approach these conversations to ensure that our patients feel comfortable telling us what’s important to them in setting priorities for their care.”