Advance Care Planning: Empowering Singaporeans to Shape Their Future Healthcare

Advance care planning (ACP) is a meaningful process that empowers individuals to make informed decisions about their future medical care. It involves expressing preferences regarding medical treatment, end-of-life care, and appointing trusted individuals to make decisions on their behalf if they become unable to do so.

Why Advance Care Planning Matters in Singapore

Singapore's rapidly aging population highlights the importance of ACP. According to the Ministry of Health (MOH), by 2030, one in four Singaporeans will be aged 65 or older. This demographic shift underscores the need for proactive planning to ensure that individuals receive the care they desire as they age or encounter unforeseen circumstances.

ACP allows individuals to:

• Preserve autonomy: Express their wishes and preferences regarding their medical care, ensuring that their values and beliefs are respected.
• Reduce burden on loved ones: Relieve family members and friends of the difficult task of making medical decisions on their behalf, especially during emotional times.
• Improve quality of care: Ensure that their care is aligned with their preferences, reducing the likelihood of unwanted treatments or interventions.
• Promote peace of mind: Provide a sense of security and control over their healthcare journey, knowing that their wishes will be honored.

Benefits of Advance Care Planning

• Enhanced communication: Facilitates open and comfortable discussions between individuals and their healthcare providers about their end-of-life care preferences.
• Improved coordination of care: Creates a roadmap for healthcare providers to follow, ensuring seamless and patient-centered care.
• Reduced conflicts: Minimizes disputes among family members and healthcare professionals by providing clear instructions regarding an individual's wishes.
• Lower healthcare costs: Reduces unnecessary medical interventions and hospitalizations by aligning care with an individual's goals and values.

Common Mistakes to Avoid in Advance Care Planning

• Delaying the process: ACP should not be postponed until an individual faces a life-limiting illness. It is an ongoing conversation that should start early and be revisited periodically.
• Assuming loved ones know your wishes: Even close family members may not be aware of your specific preferences. It is essential to explicitly express your desires in a formal document.
• Not completing the forms: Advance care planning forms, such as the Advance Medical Directive (AMD) and Lasting Power of Attorney (LPA), are legal documents that must be properly completed. Seek guidance from a healthcare professional or lawyer to ensure validity.
• Overreliance on technology: While apps and online tools can facilitate ACP, they should not replace face-to-face discussions with healthcare providers and loved ones.
• Ignoring spiritual and emotional aspects: ACP should not focus solely on medical interventions but also consider spiritual, cultural, and emotional preferences.

Expanding the Scope of Advance Care Planning: The "Care Compass"

The traditional scope of ACP has primarily focused on medical decisions. However, there is a growing recognition of the importance of expanding ACP to include a broader concept of "wellness care." This encompasses aspects such as emotional, spiritual, and social well-being, which are equally important for individuals facing life-limiting illnesses or end-of-life transitions.

The concept of the "Care Compass" is emerging as a potential tool to facilitate this expanded approach to ACP. It is a comprehensive tool that incorporates medical, wellness, and spiritual care preferences into a single document. The Care Compass allows individuals to:

• Express their holistic values and preferences: Go beyond medical decisions to include aspects of emotional, spiritual, and social care, ensuring that all dimensions of their well-being are aligned.
• Provide guidance to family and caregivers: Offer clear instructions not only for medical care but also for end-of-life care arrangements, funeral wishes, and spiritual support.
• Promote a sense of purpose and meaning: Help individuals find meaning and purpose in their care journey, even during challenging times.

Creating a Care Compass for Your Future

Crafting a Care Compass requires thoughtful consideration and involvement from multiple perspectives. Here are some steps to guide you in creating a meaningful and comprehensive document:

1. Start the conversation: Engage in open and honest discussions with family members, friends, and healthcare providers about your end-of-life preferences.
2. Explore your values and beliefs: Reflect on what matters most to you in terms of medical care, personal dignity, spiritual well-being, and relationships.
3. Consider various care settings: Think about where you would prefer to receive care, such as at home, in a nursing home, or in a hospital.
4. Research and consult: Gather information from trusted sources, including your healthcare provider, religious or spiritual leaders, and legal professionals.
5. Use the Care Compass framework: Utilize the Care Compass template to organize your preferences and decision-making instructions.
6. Complete the legal forms: Ensure that your Advance Medical Directive (AMD) and Lasting Power of Attorney (LPA) are properly completed and signed.
7. Share and review regularly: Discuss your Care Compass with loved ones and healthcare providers, and revisit it periodically to ensure it reflects your current wishes.

Empowering Individuals Through Advance Care Planning

Advance care planning is an empowering tool that empowers individuals to navigate their healthcare journey with confidence and dignity. By engaging in open conversations, completing legal forms, and exploring the expanded concept of the Care Compass, Singaporeans can ensure that their values and preferences are respected, reducing uncertainty and providing peace of mind for themselves and their loved ones.

Additional Information

Key Resources for Advance Care Planning in Singapore

• Ministry of Health (MOH): https://www.moh.gov.sg/content/moh_web/home/policies/advance-care-planning.html
• National Healthcare Group (NHG): https://www.nhg.com.sg/services/patient-care/advance-care-planning
• SingHealth: https://www.singhealth.com.sg/patient-care/services-treatments/advance-care-planning
• CareCompass (online platform): https://carecompass.sg/

Useful Tables

Advance Care Planning in Different Cultures

ACP practices vary across different cultures and communities. It is important to acknowledge and respect these cultural nuances when engaging in advance care planning conversations. Some key considerations include:

• Religious beliefs: Religious beliefs and practices can influence an individual's preferences regarding end-of-life care and spiritual support.
• Family values: Family dynamics and cultural values can shape family involvement in care decisions and end-of-life arrangements.
• Communication styles: Communication patterns and cultural norms can impact the way end-of-life preferences are expressed and understood.

By being sensitive to cultural differences and seeking guidance from cultural or spiritual leaders, healthcare providers and loved ones can facilitate meaningful and culturally appropriate ACP discussions.