#42 Advance Care Planning across ages - Common ground and challenges

16.01.23

#42 Advance Care Planning across ages- Common ground and challenges

In this episode I talk with Dr Annabel Howell, Medical Director of Children’s’ hospice across Scotland, Trustee/Vice Chair at the My Name’5 Doddie Foundation and keen sportswoman.

We talk about how sport has influenced Annabel’s practice as a Dr, what Advance Care Planning with children looks like, and the differences and similarities with adult Advance Care Planning.

We talk about Advance Care Planning when living with Motor Neuron Disease and explore sensitive decision making around the withdrawal of ventilation.

We also explore Annabel’s work with the My Name’s Doddie Foundation and pay tribute to a remarkable man who died shortly after this episode was made highlighting Doddie’s ongoing legacy and impact.


Key messages from guest

  • Annabel has rowed at a high level and uses her experience  when caring for people, using transferable skills such as coping with adversity and injury and working as a team player. 

  • Annabel describes how Advance Care Planning has many similarities with adult Advance Care Planning. 

  • Complexity of need drives Advance Care Planning with children with four main categories,life threatening conditions, premature death is inevitable with long periods of intensive treatment, progressive disease with focus on palliation of symptoms and fourthly irreversible but non progressive conditions.

  • Within those four categories, there are three stages, diagnosis, MDT discussions continue with beginning What Matters Most conversations, and then moving towards care at the end of life and bereavement support. 

  • The principles are very similar to Advance Care Planning with adults. 

  • Doddie was a Scottish international player and diagnosed with Motor Neuron Disease approximately five years ago. 

  • Doddie asked Annabel to support his career and also the foundation he set up to research Motor Neuron Disease. 

  • Annable describes decision making around withdrawal of ventilation along the same lines as all potentially life sustaining treatment. 

  • The importance of normalising Advance Care Planning is highlighted by Annabel. 

  • Never forget the small things, these are the things that make a real difference. 

  • Let silence speak, we don’t have to always do, sometimes the most important thing is just to be with someone.

Resources

Bio

Annabel trained at the Royal Free Hospital and has enjoyed a variety of medical roles including director level appointments in primary and secondary care as well as clinical governance. As a palliative care specialist and previously as a GP, she has looked after many people with MND, ensuring they receive high quality person-centred care and was involved in the successful fundraising for the purpose-built palliative care unit in the Borders. Annabel also is Chair of the Scottish Partnership for Palliative Care. Her sport was rowing and she still sits on the British Rowing Medical Advisory Panel and supported the GB Rowing Team in training and competition prior to the Beijing Olympics. She lives in the Scottish Borders with her husband Julian and family.

 

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.