Consider advanced care planning in functional assessment of older peopleBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d5944 (Published 21 September 2011) Cite this as: BMJ 2011;343:d5944
- Mayur Lakhani, GP and chairman1
When assessing older people it is important to consider an advanced care plan if appropriate,1 especially when comorbidity is the rule in this group with a high prevalence of dementia.
It is therefore worth routinely asking the question: “Would I be surprised if this person died in the next 6-12 months?” If the answer is no, then a further assessment should be made for supportive and palliative care needs and to consider the patient for the general practice palliative care register.
People with non-cancer diagnoses tend to be under-represented in practice end of life care registers, which hampers care planning and sometimes leads to inappropriate hospital admissions and medical interventions.
The advent of clinical commissioning groups offers an opportunity for the development and implementation of care pathways for older people that use the skills of generalists and specialists. I urge all groups to prioritise this area and develop local models of care, including good end of life care.
Cite this as: BMJ 2011;343:d5944
Competing interests: ML is chair of the National Council for Palliative Care.