Advance care planning in critical care Potential and requirements

Background Lack of knowledge about patient preferences is a contributing factor for inappropriate therapy. Advance care planning (ACP) is a novel concept for meaningful advance directives, but it is still not widely known in Germany. Objective An overview of the concept of ACP, development and its implementation with respect to intensive care is provided. Methods A narrative literature review was performed. Results ACP is a broad concept which requires facilitated discussions with trained medical staff. The process can lead to different ACP documents. It is also possible to facilitate discussions with patient proxies. Furthermore, ACP has potential because of the proven validity of advance directives and the prompt applicability of directives in an emergency. Prerequisites for ACP include the provision of resources, notably for the training of appropriate facilitators, and the implementation or extension of counseling structures. Conclusions Advanced care planning (ACP) is a promising concept. However, some requirements must be met to implement ACP into daily practice.