The 5th International Conference on Advance Care Planning and End of Life Care (ACPEL 2015) recently held in Munich is the most important international meeting on care planning and treatment.

During four days, the most consolidated promotion and education programmes, research and local experiences were presented. You can read summaries of communications in the supplement of September of BMJ Supportive and Palliative Care.

Noteworthy is the consolidation of Respecting Choices Project led by Budd Hammes and Linda Briggs in La Crosse (Wisconsin, USA) as a center of research and education. Their promotion of advance care planning model based on the performance of certified facilitators has crossed borders: first in Australia (Bill Silvester) who adapted the process and has subsequently spread to Canada, Europe, Singapore, and so on.


I would like to highlight some of the consolidated experiences which are now reference in terms of the coordination of health care, from hospital specialists with medical personnel of primary health care and social services; in these programmes is promoted the elaboration of a plan of care and treatment in which the patient/person-citizen is the protagonist:

1. My Values program coordinated by Barwon Health (Jill Mann) in Geelong, South Australia.

2. Gold Standard Framework, in England, coordinated by Keri Thomas. Focus on the education of health workers in primary care and palliative care.

3. Living Matters From Singapore, with Lim Jingfem, started with the hospital services of Nephrology and Pulmonology, subsequently extended to all levels of care.

4. The methodology of work and evaluation coordinated by Susan Hickman at Indiana University: Research in Palliative and End-of-Life Communication and Training (RESPECT) Center.

5. The PREPARE project led by Rebecca Sudore in California.

The lessons learned were many, but can be summarized thus:

– How important is the process of communication with the patient and his environment.

– Patient preferences should be registered and known for his health care personnel.

– The training of health personnel in aspects related to the end of life is essential.

– Process of communication with the patient and their family should not be an isolated fact.

– It is necessary to evaluate the process to improve its methodology and usefulness.

Little discussed documents and records, it is not the goal.

In Spain we have made the mistake of focusing this item of planning in the number of registered documents and how to consult them. For the patient and his family the important thing is to have a plan and that a doctor and nurse involved in their design and implementation.

In this sense, our contribution to the Congress was focused on two experiences in primary care and planning with patients in dialysis, in Álava (Alava and Hospital Universitario de Álava).

I think we are in the path with what is really important: Less papers, more conversation.

Dr. Iñaki Saralegui (@InakiSaralegui)
Hospital Universitario de Álava