New First Nations Advance Care Plan Workbook

Pictured above: SVHM’s Chris Delamont, Nicole Watt, Emma Ning, Caroline Scott, Imogen Nund Dam and Nicola Gorwell all contributed to developing the new workbook (Artwork: Seven Sisters – Milky Way by Gabrielle Possum)

A new patient discussion workbook developed by St Vincent’s Hospital Melbourne (SVHM) aims to stimulate improved discussion around Advance Care Planning with First Nations patients.

This important resource has been carefully crafted by SVHM’s Advance Care Planning Program in collaboration with the Aboriginal Health Unit and Palliative Care team to ensure it is culturally safe and uses language and imagery that resonate with First Nations people.

“What I am very proud of is the extensive collaboration that has gone into this. Our teams have worked together from the very start. This is a great resource that we hope will make First Nations people feel a lot more comfortable talking about Advance Care Planning. It will also benefit our staff when they are guiding these discussions,” says Nicole Watt, Manager of SVHM’s Aboriginal Hospital Liaison Service.

An Advance Care Directive is a document that clearly outlines an individual’s preferences for their future healthcare. It is a particularly important document to have in place for when people are no longer able to communicate their preferences or make treatment decisions.

Nicole said the First Nations community has found identifying with the standard Advance Care Planning workbook challenging, and were more likely to push it aside.

“This new workbook has all the essential information needed for understanding the value of an Advance Care Directive and is presented in a way that will captivate Mob so they will be more inclined to pick it up and read it,” she added.

Design elements that are significant and relevant to the First Nations community, including First Nations artwork and imagery, were incorporated in the new look. 

“In the past, I would have been more inclined to use the standard booklet to help guide my conversations, but I wouldn’t have shared it with them. I would be happy now to sit down with a First Nations patient and work through this new booklet together because they are likely to be more engaged,” she said.

Why you need to plan ahead

Close to 50 per cent of Australians who reach end-of-life haven’t considered Advance Care Planning. Instead, they suddenly find themselves in a position where they are no longer fit, or able, to make a decision about their treatment.

Although most people associate an Advance Care Directive with end-of-life, it is important to recognise the value in having one in place a lot earlier. It not only highlights a nominated person to make healthcare decisions on an individual’s behalf when they are no longer able to do so, but also indicates their preferences in healthcare and medical treatment.

“This is a conversation that can, and should, be had at any time in our life. It is relevant to everyone,” said Emma Ning, clinical nurse with SVHM’s Advance Care Planning Program.

“Family members who may become decision makers can feel more at ease when they know what their loved one wants. Our goals for care align better when we know what our patient’s preferences are.

”Determining who will be your key decision maker is one critical aspect. Nicole highlighted that for First Nations people there are some differences in how they determine their ‘key people’ in life.

“Often in non-Indigenous families, your key person may be your partner and they are identified as your next of kin. First Nations families may nominate someone you may not be expecting, such as a niece or a friend as their key person, rather than their partner,” explained Nicole.

The new booklet will be used by SVHM teams across the hospital’s various services.

“It provides our clinical staff with a resource that will assist them in better framing conversations with First Nations patients around Advance Care Planning, especially at times when these patients and their families may be feeling very vulnerable,” said Nicole.