Advanced decision planning (PDA) in patients suffering from degenerative, advanced or terminal diseases is something that improves health management in the final stage of the patient's life. It is a procedure that would guarantee respect for the autonomy of patients when they lose the ability to decide. In addition, it provides them with health support, something essential for the patient and his family at this stage, avoiding invasive treatments that cause more emotional discomfort.
Patients likely to receive Advance Decision Planning
There are patients classified as Patients with Complex Chronic Disease (CCP) and Patients with Advanced Chronic Disease (MACA). The former have a prevalence of 3.5 - 5% of the population and are characterized by pluripatology. Its evolution is dynamic and requires a great use of emergency services, consumption of health resources, drugs and health care. On the other hand, patients with MACA account for 1.5% of the population, with a clinical profile similar to that of CCPs, but also suffer from a more serious clinical involvement, with a perception of limited life expectancy.
What is Advance Decision Planning and what benefits does it bring?
PDA is a way to allow these groups of patients with advanced diseases, to express their will when they are in an irreversible process with poor prognosis. However, there are cases where it is difficult due to the patient's clinical or mental situation, since he can not express his will and are not documented in a medical history. This makes their preferences uncertain and generates discomfort in the family.
When should Advance Decision Planning be done and why?
If it is desired to perform a correct PDA, it is important to do so when the terminal disease is still at an early stage. It is important to emphasize that when the patient is not able to express his will and appear complications, it is the family that must participate in that decision-making. This is sometimes a complication, because the family is not aware of it, and they play an important role at the end of the patient's life.
It is important that the specialist in Geriatrics get good communication with the patient. In this way, it will allow you to transmit adequate information about the disease and take into account the patient's values, so that he may also participate in the decision-making process. To achieve this communication, professionals must be trained in attitudes, knowledge and communicative skills, always with the aim of properly accompanying the patient and the family, respecting their values and desires in the last stage of life.