Instead of having a stagnant care plan that doesn’t change as a person ages, people should use “adaptive care planning” to plan for the possibility of facing a serious illness later on, according to a new report. The flexible model will let clinicians, patients and families modify care plans on an ongoing basis so it accommodates changes that may occur.
The framework was unveiled in a report out Tuesday in the Journal of the American Geriatrics Society.
Adaptive care planning, or AdaptCP, takes into account evolving communication between physicians and patients/families with ongoing incorporation of the patient’s perspective, or that of their family’s. Each decision can be made that aligns with those desires and is consistent with an individual’s medical needs.
The model can unfold in several steps. First, the care provider must ensure the individual and their loved ones understand the individual’s medical status as it is. Then care teams need to share information tailored to the person’s situation. The next step is to identify possible options for care and to assist patients and their families in creating a plan of care that’s consistent with their goals and values for that point in time. Following up as needed is key to ensure that the care team can shift the plan in the event of any health changes.
“The solution requires a paradigm shift from advanced care planning to AdaptCP. In the AdaptCP model, conversations happen iteratively over time, in the setting of serious health conditions, and decision-making occurs at key decisional points rather than exclusively at end of life,” the authors wrote.
In other words, discussions about care planning happen in different ways with AdaptCP, because it forces people to imagine potential outcomes they may have (all while relatively healthy). Then, the individual has to make decisions about the type of treatment they may prefer if a serious illness occurs, and do it all with loved ones who may have differing opinions.
In related news, a report released Tuesday in the same journal found that surrogate decision-makers from historically marginalized populations have lower levels of preparedness for care planning.
