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Is there an ideal time to discuss advance care planning?
Advance care planning (ACP) is appropriate for all patients with kidney disease and not merely reserved for the elderly, frail, or those suffering from a terminal illness.
It is not necessarily limited to the end-of-life context, but includes decision making about curative, invasive, or advanced therapies throughout the illness course. When dealing with a CKD population, a discussion of ACP topics should therefore be woven throughout longitudinal interactions with patients.
Who should be involved in Advance care planning?
Evidence suggests that patients think communication about ACP topics is important. Specifically, stronger involvement of the nephrologist is something that patients may desire when it comes to discussing their values and preferences. This process should also involve family and caregivers who often serve as surrogate decision makers when a patient no longer has capacity or is too medically ill to participate in end-of-life decision making.
