#27 Frailty and Advance Care Planning with Dr Patricia Cantley

In this episode I talk with Consultant Geriatrician Dr Patricia Cantley about frailty, triggers for Advance Care Planning and the famous Paper Boat story. Dr Cantley shares personal experiences of Advance Care Planning with family members, and we reflect on planning ahead as part of everyday life.

Novo Nordisk supplied sponsorship to produce this episode.  Novo Nordisk has had no influence in the creation, development or content of this podcast and full control remains the responsibility of Clare Fuller.

Key messages from guest

• Advance Care Planning (Anticipatory Care Planning) is integral to everyday life.

• Frailty is recognised as a key concept of care in older life and can be summarised as how much reserve you have to survive the stresses and strains of everyday life. 

• Frailty can be considered on an individual or population basis. 

• Advance Care Planning is an iterative process, changing through life. There are triggers to this such as making a will, or talking to your GP about your plans for the future.

• There are triggers such as a key illness, or a hospital admission which can be the start of an Advance Care Planning conversation. 

• Advance Care Planning is a chance for a person to take control or resume autonomy.

• We should all normalise these discussions.

• Realistic Medicine is a movement in Scotland and  focuses on person centred care and what matters most to a person.

• Anyone can have an Advance Care Planning conversation. 

• We can make assumptions as Health Care Clinicians, and are not always good at finding out what matters most to our patients. 

• Advance Care Planning can and should change over time.

• Tricia shares the very different experiences of end of life care for her grandparents and the impact this has had. 

• Tricia shares the need to communicate plans and prepare for crises.

Resource

• British Geriatrics Society information on Frailty 

• NHS Frailty Index 

• Rockwood Score 

• See the SPICT4ALL resource

• For information on realistic medicine see Working together to provide the care that’s right for you  Demonstrating professionalism through approach, behaviour and attitudes of Realistic Medicine 

• Living with Dying Living With Dying by Margaret McCartney

• Being Mortal by Atul Gawande Being Mortal by Atul Gawande 

• See the Scottish Key Information Summary 

• Read the blog Mind the Gap by Dr Patricia Cantley 

• Find out more about  the Evaluation of an anticipatory care planning tool for care home residents and their families by Dr McMackay

• Listen to the podcast Donating your body for medical education with Kim Claridge

• Read the The Paper Boat by Dr Patricia Cantley

Bio: Dr Patricia Cantley

“I am an NHS consultant working in the field of Medicine of the Elderly. I aspire to making the world a better place and thoroughly enjoyed being part of the medical management team from 2004 to 2013 within NHS Lothian.

From January 2014 to March 2022, I worked with the team in Midlothian to develop and work on the Hospital at Home service within the area. The Midlothian Enhanced Rapid Response & Intervention Team is part of an integrated service within the Health and Social Care Partnership. The team offer an alternative to hospital admission for frail older patients with a variety of conditions, including use of intravenous therapies in the home where appropriate.

I love teaching, from work experience school kids through to consultant and general practitioner colleagues. I also like to teach non medical colleagues and to demystify medical matters for a wider audience.

My passion is to improve care for people reaching the end of their lives, particularly for those who die in the setting of a general hospital. We can and must do better in our provision of end of life care. My expertise is in the care of patients dying of diseases other than cancer, and to help them and their families at this key time.”

Learning new things everyday: website

Find out more about my Bespoke Consultancy

• Service analysis for teams seeking to improve EoLC or prepare for CQC

• End of Life Care Education

• Lasting Power of Attorney Consultancy

• Talks and presentations

If you’d like to find out more about my work contact me.

What one thing will you do?

It would be great to share what resonated with you from this episode, what is the one thing you will do differently? Head to Twitter, Facebook or LinkedIn to continue these important conversations.

Thanks to all my guests for working with me to share their knowledge, experience and stories about Advance Care Planning. I hope you enjoyed listening and have insights to take away; I love hearing your reflections on the series and look forward to reviews on Spotify where you can also subscribe to the series.

Clare

Important Conversations about Important Conversations.