8th International Advance Care Planning (ACP-i) Conference

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ACP-i 2023 Topics & Speakers

ACP-i 2023 Topics & Speakers

Click on the sessions below for more details on the presentations. All times listed are in Singapore time UTC +8.

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Please note that the programme is subject to change without notice. 

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7:30 AM – 8:30 AM 

Registration

8:30 AM – 12:30 PM

Pre-Conference
Workshop 1

Venue: Academia

Shared Decision Making in Serious illness

Pre-Conference Workshop 1: Shared Decision Making in Serious illness
Venue: Academia
Address: 20 College Road, Singapore 169856
Room: White Space Conference Room, 2nd Level

Shared decision making in serious illness is foundational for person centered care. Through didactic lectures, facilitated discussions and small group role plays, learn how one can best hold goals of care conversations in serious illness. This workshop is based on the Shared Decision Making in Serious Illness (SDMSI) curriculum of Respecting Choices.

 Dr. James (Jay) Joseph - United States

Pre-Conference
Workshop 2

Venue: KKH

ACP in Paediatrics

Pre-Conference Workshop 2: ACP in Paediatrics
Venue: KK Women’s and Children's Hospital (KKH)
Address: 100 Bukit Timah Rd, Singapore 229899
Room: Women’s Tower 1, Lecture Theatre

This workshop teaches the principles of ACP in Paediatrics, the context in which is occurs and how one can optimally engage children and parents in serious illness conversations. A framework for ACP will be presented and some important nuances discussed.

 Prof. Jenny Hynson - Australia
Assoc Prof. Chan Mei Yoke - Singapore

Pre-Conference
Workshop 3

Venue: NTFGH

Definitions, Priorities and Action: Community Engagement, Compassionate Communities and Death Literacy

Pre-Conference Workshop 3: Definitions, Priorities and Action: Community Engagement, Compassionate Communities and Death Literacy
Venue: Ng Teng Fong General Hospital (NTFGH)
Address: 1 Jurong East Street 21, Singapore 609606
Room: Excellence, 1st Level Tower A

Public health approaches to end-of-life care show promise in promoting death literacy and “die-logues”. Learn how one can apply principles of the Compassionate Communities movement to foster community activation and ACP within our local networks.

 Dr. Heather Richardson - United Kingdom
 Prof. Amy Yin Man Chow - Hong Kong
 Dr. Kerrie Noonan - Australia
 Ms. Ngiam Su-Lin - Singapore

Pre-Conference
Workshop 4

Venue: CHI

Ethics in ACP

Pre-Conference Workshop 4: Ethics in ACP
Venue: Centre For HealthCare Innovation (CHI)
Address: 18 Jalan Tan Tock Seng, S308443
Room: : Hall One, 2nd Level

Engaging our patients on what truly matters to them is an imperative in serious illness care. While ACP is at its core, an ethical practice, ethical dilemmas may engender moral distress in practitioners. Through real life case examples, this workshop illustrates decision making approaches in such dilemmas.

 Mr. Bernard “Bud” Hammes - United States
 Dr. Esther Ho Peiying - Singapore

12:30 PM – 1:30 PM

Lunch

7:30 AM – 8:30 AM 

Registration – Day 1

8:30 AM – 8:35 AM 

Introductory Videos

8:35 AM – 8:40 AM 

Welcome Address by AIC CEO

8:40 AM – 9:00 AM 

Opening Address by GOH

9:00 AM – 9:30 AM 

Keynote 1:

A Partnership between Professionals and the Public: A New Starting Point for ACP

Keynote 1: A Partnership between Professionals and the Public: A New Starting Point for Advance Care Planning (ACP)

ACP has historically been a professional activity – initiated, led and reported by clinical and other practitioners who take responsibility for discussing future plans with individuals deemed to be approaching the end of life, then disseminating their detail to colleagues who might need to act on the plans.

There is good evidence in the UK that despite best efforts on the part of professionals this approach has limited success. People often fail to appreciate or take advantage of the opportunities of ACP with consequences for their experience of dying and loss on the part of those close to them.

This presentation proposes a new starting point and alternative foci of effort.  It invites community members and groups to become active participants in ACP including its initiation and enactment. It calls for partnership working between the public and professionals related to behaviour change and accountability key to success.  Shared death literacy is a vital element

 Dr Heather Richardson - United Kingdom

9:30 AM – 11:00 AM 

Plenary 1 : ACP and Culture

1. Acculturating to Advance Care Planning

Plenary 1: ACP and Culture

1. Acculturating to Advance Care Planning

Effective advance care planning requires thoughtful consideration of culture, as ACP brokers the exchange of individual values, goals, preferences with the resources of the healthcare system. In this plenary, we explore core elements of intercultural health communication to contextualize advance care planning to cultural norms and healthcare ideals across international settings.  

 Dr. Jia Zhimeng - Canada

2. The Role of Religiosity and Spirituality in ACP: How to Navigate ACP Among Devout Populations

Plenary 1: ACP and Culture

2. The Role of Religiosity and Spirituality in ACP: How to Navigate ACP Among Devout Populations

In many cultures, religion and spirituality are key drivers shaping our deeply held values which further influence their decision-making, including ACP. Evidence showed that strong religiosity (self-perceived importance of religion) is often associated with low engagement in advance care planning. This session will dive into the role of religiosity and spirituality in ACP and how to navigate ACP among religiously devout patients and family members.

 Dr. Diah Martina - Indonesia/ Netherlands

3. Participatory Action Research to Foster “Die-logues” and Organic Conversations on ACP

Plenary 1: ACP and Culture

3. Participatory Action Research to Foster “Die-logues” and Organic Conversations on Advance Care Planning

Participatory action research (PAR) is an approach to empirical investigation that empowers everyday people to critically examine their own lived experience, understand the communal challenge that they face, and become change agents in solving their own problems. It is social change-oriented research that foster collaboration, reflectivity, and emancipation. Using an example of a randomized control trial of the Family Dignity Intervention, this presentation will illustrate how PAR may lead to organic end-of-life discussions in the community.

Dr. Andy Hau Yan Ho - Singapore

11:00 AM – 11:30 AM

Morning Tea – Day 1

11:30 AM – 1:50 PM

Plenary 2 : Evaluation of ACP Outcomes

1. The Evolution of Advance Care Planning

Plenary 2 : Evaluation of ACP Outcomes

1. The Evolution of Advance Care Planning

The practice of advance care planning (ACP) has evolved from a narrow focus on forms to a continuum of care planning focused on preparing people and their surrogate decision makers for communication and medical decision-making. To move ACP clinical care and research forward, we must reconceptualize care planning as a holistic, ongoing process over the life course that includes both tailored in-the-moment and advance decisions at every life stage. This new way of thinking about ACP will require a systems-level approach using evidenced-based methods of implementation science and human factors engineering as well as the inclusion of diverse communities and interdisciplinary experts to develop and evaluate processes to support the continuum of care planning in real world settings.

 Dr. Susan Hickman - United States

2. Implementing Advance Care Planning in Acute Hospitals: Early Lessons and Outcomes

Plenary 2 : Evaluation of ACP Outcomes

2. Implementing Advance Care Planning in Acute Hospitals: Early Lessons and Outcomes

The national Advance Care Planning (ACP) program in Singapore was started in 2011 and is modelled after the Respecting Choices paradigm. We will discuss the key findings and lessons from an early evaluation of the program, and the need for a transformational of cultural, health systems, and behavioural norms to sustain its practice in acute care settings. To assess the progress and success of ACP, we need to establish patient-centred and policy-relevant outcome measures. Challenges faced in the choice, measurement, and interpretation of outcomes included in our evaluation, will be discussed.

Prof. Tan Woan Shin - Singapore

3. Complexity of Implementing a National ACP Program: Experiences from Singapore

Plenary 2 : Evaluation of ACP Outcomes

3. Complexity of Implementing a National Advance Care Planning Program: Experiences from Singapore

The implementation of advance care planning (ACP) is complex. In this talk, I will share the learnings from the evaluation of the second phase of the Singapore’s national ACP program. Findings provided an insight into the multiple health care system challenges that ACP programs face. To integrate ACP within routine clinical care, ACP processes should be simplified, training framework be strengthened, physicians be engaged and an ACP supportive culture be created within and outside organisations. The purpose of ACP needs to be carefully rethought, and appropriate monitoring and evaluation indicators be accordingly agreed upon.

 Dr. Chetna Malhotra - Singapore

4. Evaluation of Care Consistency with Care Preferences: Lessons from the German BEVOR Trial

Plenary 2 : Evaluation of ACP Outcomes

4. Evaluation of Care Consistency with Care Preferences: Lessons from the German BEVOR Trial

Care consistent with care preferences for patients incapable of decision-making is often referred to as the central goal of ACP. Evaluation of goal achievement, however, remains methodologically challenging. In the German BEVOR trial, we developed an instrument to measure retrospectively whether care delivered was consistent with care preferences (3CP) in nursing home (NH) residents.

Firstly, we identified all potentially life-threatening events and related treatment decisions in the past three months from the NH records. We then assessed 3CP based on four different sources: NH records and interviews with resident (if possible), surrogate and nurse. 3CP was evaluated on two levels: (1) apparent consent/refusal (versus preferences unknown), and if known (2) quality of the underlying shared decision-making (SDM) process based on central SDM elements: information about medical situation and options, deliberation and supported choice of treatment. Looking forward to sharing and discussing our experiences in developing and applying the 3CP instrument.

Prof. Georg Marckmann - Germany

5. Improving the Quality and Effectiveness of ACP Conversations through Conversation Analysis

Plenary 2 : Evaluation of ACP Outcomes

5. Improving the Quality and Effectiveness of ACP Conversations through Conversation Analysis

Good conversations clarify and connect people’s true values and preferences with the care they receive. Conversation analysis is an approach to the study of social interaction, verbal and non-verbal, in situations of everyday life. It can lend insights to promoting better quality ACP.

Dr. Luke Kang Kwong - Singapore

1:50 PM – 2:50 PM

Lunch – Day 1

2:50 PM – 4:05 PM

Breakout Session 1a

Theme: Implementing ACP on Regional and National Levels

1. A Whole-System Population Approach to ACP in End-of-Life Care, Using the UK’s Gold Standards Framework

Theme: Implementing ACP on Regional and National Levels

1. A Whole-System Population-based Approach to Advance Care Planning for Proactive, Personalised Palliative/End-of-Life Care, using the UK’s Gold Standards Framework

Advance Care Planning (ACP) benefits everyone, particularly people in their final years of life, navigating between different sectors, systems and care-providers. Can whole-system public-health approaches reduce the current lottery of care? Gold Standards Framework (GSF) is an evidence-based, quality improvement end-of-life care (EOLC) programme, used for 25 years across the UK, involving thousands of generalist frontline health/social care teams in different settings -primary care, hospitals, nursing homes, homecare, hospices, prisons and Integrated care sites. Focusing on enablement, democratising and de-medicalising ACP, GSF helps more proactive, personalised, joined-up EOLC across wider populations.

The synergistic impact of whole-system, population-based thinking in outcomes and culture change, is described -greater than the sum of its parts. Earlier identification registers (proactive care), mainstreaming ACP discussions (personalised care), care aligned to preferences, reducing over-hospitalisation (coordinated, goal-concordant care), can reliably create benefits for more people, health economies and wider populations.

Assoc. Prof. Keri Thomas, United Kingdom

2. Catering for Diverse Needs - Future Care Planning in Wales

Theme: Implementing ACP on Regional and National Levels

2. Catering for Diverse Needs - Future Care Planning in Wales

In Wales, the term ‘future care planning’ was introduced in 2017, to include patients with diminished mental capacity and their significant others. Over the last 5 years, work has been undertaken to create education formats, resources and national documents. Key strategic approaches in Wales with regard to future care planning will be presented, including communication strategies and how different formats can help widen choice. The approach seeks to cater for the disparate need of the Welsh population; there is not merely one format for multiple scenarios, but a choice of approaches, communication strategies and documents to suit bespoke needs.

 Prof. Mark Taubert, United Kingdom

3. Applying Science to Practice – Developing a Quality ACP Framework for Singapore

Theme: Implementing ACP on Regional and National Levels

3. Applying Science to Practice – Developing a Quality ACP Framework for Singapore

In this session, the speakers aim to share the background work, which is in-progress, in attempting to develop a national framework and guideline for implementing quality Advance Care Planning (ACP) in Singapore, utilising knowledge translation principle, pioneered by the Knowledge Translation Program (KTP), Unity Health Toronto, under the leadership of Dr Sharon Straus. This sharing will allow participants to appreciate how knowledge translation and implementation science principles can be used to develop and implement new services/programmes/policies/frameworks that are relevant to practice.

Assoc. Prof. James Alvin Low, Singapore
Ms. Nongluck ("Nink") Pussayapibul, Singapore

Breakout Session 1b
Theme: ACP and Culture

1. Supporting Clinicians to Adopt a Culturally Considerate Approach to ACP Conversations with Patients

Theme: ACP and Culture

1. Supporting Clinicians to Adopt a Culturally Considerate Approach to ACP Conversations with Patients

Dr. Eman Hassan - Canada

2. Japanese Nurse’s Perspectives about Death and Dying and End of Life Decision Making

Theme: ACP and Culture

2. Japanese Nurse’s Perspectives about Death and Dying and End of Life Decision Making

Ms. Yumi Naito, Australia

3. My Life Choices Project – Attitudes and Perceptions on ACP among Chinese-speaking Older Australians Living in Sydney

Theme: ACP and Culture

3. My Life Choices Project – Attitudes and Perceptions on ACP among Chinese-speaking Older Australians Living in Sydney

Ms. Ling Yeoh, Australia

4. The Creation of an Easy Read ACP Workbook

Theme: ACP and Culture

4. The Creation of an Easy Read Advance Care Planning Workbook

 Ms. Cari Borenko, Canada

Breakout Session 1c
Theme: Patient Empowerment in ACP

1. Is Self-Efficacy Associated with Readiness to Engage ACP among Medical University Students in Taiwan?

Theme: Patient Empowerment in ACP

1. Is Self-Efficacy Associated with Readiness to Engage ACP among Medical University Students in Taiwan?

Dr. Cheng-Pei Lin, Taiwan

2. The Tripartite Dynamism in Advance Care Planning: from Attitude to Initiation

Theme: Patient Empowerment in ACP

2. The Tripartite Dynamism in Advance Care Planning: from Attitude to Initiation

Ms. Margaret HP Suen, Hong Kong

3. Importance of Health Literacy and Knowledge Regarding Advance Care Planning Among Older Adults in Switzerland

Theme: Patient Empowerment in ACP

3. Importance of Health Literacy and Knowledge Regarding Advance Care Planning Among Older Adults in Switzerland

Mr. Clément Meier, Switzerland

4. Re-thinking ACP with a Life Journey and Asset-Based Approach

Theme: Patient Empowerment in ACP

4. Re-thinking Advance Care Planning with a Life Journey and Asset-Based Approach

Dr. Jessica Simon, Canada

4:05 PM – 4:35 PM

Afternoon Tea – Day 1

4:35 PM – 6:10 PM

Breakout Session 2a
Theme: ACP in Asia

1. ACP in Hong Kong: Shifting from Why to How

Theme: ACP in Asia

1. ACP in Hong Kong: Shifting from Why to How

The importance of ACP has gained recognition in Hong Kong over the last two decades. Research evidence has shown that various ACP programmes are well received by care recipients and family caregivers across hospitals, community care, home care services and residential care homes. Given a new advance directive bill is in the pipeline, it is timely to devise a systematic approach for the delivery of ACP services. This presentation will review the current service development, identify challenges that might threaten its sustainability, and discuss various means and strategies to cultivate a conducive environment for ACP implementation.

Prof. Helen Chan - Hong Kong

2. ACP Development in South Korea

Theme: ACP in Asia

2. ACP Development in South Korea

In Asian countries, including Korea, the autonomy associated with the end of life was not as guaranteed as in Western countries. In the past, it was often determined by children who had economic and cultural initiatives in the home, especially if their parents had terminal illness. These cultures have been widespread not only in the hospice-palliative area but also acute care setting until recently but some consensus about life sustaining treatment and patient autonomy was formed due to several historical events. After these series of events, we felt the necessity of legislation related to life-sustaining treatment and had discussed for this issue since 2010. As a result, ‘the Act on decisions on life-sustaining treatment for patients in hospice and palliative care or at the end of life’ (Act No. 14013) was announced in March of 2016 and this Act enforced in February in 2018. Now, personal autonomy is respected for legal reasons at least. However, these autonomy is still in the very early stages, and there seems to be a cultural and social need to mature. In addition, further medical research related to patient autonomy is likely to be needed.

Prof. Sun-Hyun Kim - South Korea

3. ACP in Indonesia: The Interface of Culture and Religion

Theme: ACP in Asia

3. ACP in Indonesia: The Interface of Culture & Religion

Indonesia is a lower-middle-income country and the fourth most populated nation in the world. Like many other Asian countries, Indonesia is also highly collectivist. In addition, Indonesia has the largest Islamic population in the world and is one of the most religious countries worldwide, where faith drives many aspects of life, including healthcare decision-making and ACP. The presentation will describe research findings on the practice of ACP among cancer survivors in Indonesia and how it is influenced by the perspectives on ACP among Indonesian patients, family members, and healthcare professionals. The talk will also review the research findings of perceived barriers and facilitators to the practice of ACP in Indonesia.

Dr. Diah Martina - Indonesia

4. The Advance Care Planning Development in Taiwan: Past, Present, and Future

Theme: ACP in Asia

4. The Advance Care Planning Development in Taiwan: Past, Present, and Future

This presentation will start with a case study regarding decision-making dilemma on life-sustaining treatment for patients and their family members. Two relevant legislations (i.e. Hospice and Palliative Care Act and Patient Right to Autonomy Act) will be introduced to elaborate the case study with possible options for medical decision-making. Then social movement for patient autonomy enlightening by the practice challenges, and the advance care planning (ACP) development will be shared. The current implementation of ACP and public propaganda to facilitate ACP at different levels (i.e. system level, organizational level, and individual level) will also be reported with reflections and future implications.

Dr. Cheng-Pei Lin - Taiwan

Breakout Session 2b
Theme: ACP and Culture

1. The Role of Acculturation in the Process of ACP Among Chinese Immigrants: A Narrative Systematic Review

Theme: ACP and Culture

1. The Role of Acculturation in the Process of ACP Among Chinese Immigrants: A Narrative Systematic Review

Ms. Tingting Zhu - The Netherlands

2. Advance Care Planning Among Older Adults of Moroccan Origin: An Interview-Based Study

Theme: ACP and Culture

2. Advance Care Planning Among Older Adults of Moroccan Origin: An Interview-Based Study

Dr. Hakki Demirkapu - Belgium

3. Developing a Culturally Appropriate ACP Program in Long-term Care Facilities in China: Stakeholder Theory of Change Workshops

Theme: ACP and Culture

3. Developing a Culturally Appropriate ACP Program in Long-term Care Facilities in China: Stakeholder Theory of Change Workshops

 Mrs. Yuxin Zhou - United Kingdom

4. Advance Care Planning- type Behaviours in Older non-native Language Speakers in Switzerland

Theme: ACP and Culture

4. Advance Care Planning- type Behaviours in Older non-native Language Speakers in Switzerland

Dr. Laura Jones - Switzerland

Breakout Session 2c
Theme: Programme Development and Evaluation

1. What Makes ACP Effective? Necessary Elements Determined by a Theory of Change

Theme: Programme Development and Evaluation

1. What Makes ACP Effective? Necessary Elements Determined by a Theory of Change

Prof. Berend Feddersen - Germany

2. Facilitators and Barriers to Stakeholder Engagement in ACP for Older Adults in Community Settings: A Mixed-research Systematic Review

Theme: Programme Development and Evaluation

2. Facilitators and Barriers to Stakeholder Engagement in ACP for Older Adults in Community Settings: A Mixed-research Systematic Review

Ms. Monika Pilch - Ireland

3. A Provincial Whole-systems Approach to Promoting Conversations that Matter

Theme: Programme Development and Evaluation

3. A Provincial Whole-systems Approach to Promoting Conversations that Matter

Dr. Eman Hassan - Canada

7:30 AM – 8:30 AM 

Registration – Day 2

8:30 AM – 9:00 AM 

Keynote 2:

Theory-informed, Tiered and Multistage Holistic Advance Care Planning Model

Keynote 2: Theory-informed, Tiered and Multistage Holistic Advance Care Planning Model

Advance Care Planning (ACP) has been taken as a “one-size-fits-all” intervention for all, but readiness in ACP and the health status of the person concerned are found to influence the content and strategies of ACP. Integrating the Transtheoretical Model (TTM) on health-related behaviors and classification of disease prevention model in Public Health, a tiered and multistage model of ACP is developed. This presentation will outline this model and its practices with Chinese Persons in Hong Kong.

 Prof. Amy Chow - Hong Kong

9:00 AM – 10:50 AM 

Plenary 3 : ACP in Special Populations

1. Upholding Personhood with ACP in Dementia

Plenary 3: ACP in Special Populations

1. Upholding Personhood with ACP in Dementia

People with dementia present special challenges in ACP. The key issues that come to mind include mental capacity, the ability and willingness to accept the dementia diagnosis and make plans for the future, and the role of surrogate decision makers. This session will attempt to address these challenges while remaining focused on both the person and the process.

 Prof. Philip Yap Lin Kiat - Singapore

2. Optimising Decision-Making for Seriously Ill Children

Plenary 3: ACP in Special Populations

2. Optimising Decision-Making for Seriously Ill Children

How do we best conceptualise paediatric ACP and what are its potential benefits and limitations? What decision-making approaches for children with life-limiting conditions enable family-centered care? Associate Professor. Jenny Hynson draws upon her life’s work to help us navigate these questions.

 Prof. Jenny Hynson - Australia

3. Nuts and Bolts of Shared Decision Making in Serious Illness

Plenary 3: ACP in Special Populations

3. Nuts and Bolts of Shared Decision Making in Serious Illness

Shared decision making is a process in which clinicians and patients work together to make treatment decisions in a way that balances clinical evidence on risks and expected outcomes with patient preferences and values. Researchers find enormous gaps between what patients want and what doctors think they want.
Shared decision making requires open and respectful communication between the patient and physician, but myriad factors can undermine this type of exchange. For example, both patient and physician may approach the conversation with pre-conceived notions that hinder the shared decision-making process. This session will review the essential elements that must be present for shared decision making to occur, and strategies to facilitate shared decision making.

 Dr. Carole Montgomery - United States

4. Implementing Shared Decision Making in Serious Illness in a Palliative Care Service in USA

Plenary 3: ACP in Special Populations

4. Implementing Shared Decision Making in Serious Illness in a Palliative Care Service in USA

Person-centered communication (PCC), including advance care planning and shared decision-making in serious illness, is a complex, iterative process which is essential to the delivery of goal-concordant care. Advancing PCC in an American, rural, integrated health system requires identification and mitigation of numerous potential barriers. A “5E” framework was developed and implemented. The 5Es are education, electronic medical record (EMR), engagement, evidence, and execution. During this plenary, participants will hear some of the challenges to advancing PCC and how the 5E framework can help overcome those challenges. Participants will be encouraged to consider how a similar structured approach can help them overcome potential barriers in their settings.

 Dr. James (Jay) Joseph - United States

10:50 AM – 11:20 AM

Morning Tea

11:20 AM – 12:40 PM 

Plenary 4 : ACP Across the World

1. ACP in Japan: Cultural Considerations and the Way Forward

Plenary 4: ACP Across the World

1. ACP in Japan: Cultural Considerations and the Way Forward

Japanese people share some psychocultural-social tendencies that include “surmise,” “self-restraint,” “air,” “peer pressure,” and “community”.

In this context, implicit communication and family-centered decision-making in medicine have been a culturally appropriate practice. In 2018, the Japanese government revised guidelines on end-of-life decision-making and officially introduced the concept of advance care planning (ACP). Since then, awareness of ACP has rapidly increased in and outside of the healthcare system. In this presentation, we will first review the unique psychocultural-social tendencies relevant to ACP in Japan. Second, we will summarize the development and current status of ACP in Japan. Lastly, we will discuss various initiatives to facilitate ACP through patient care, education, research, policy making, and public awareness. To develop and implement culturally appropriate A CP models, further efforts should be made to address how to respect patient preferences through shared decision-making whilst ensuring that family harmony is maintained.

 Dr. Masanori Mori - Japan

2. ACP in Thailand

Plenary 4: ACP Across the World

2. ACP in Thailand

Updates on ACP implementation and practice in Thailand.

 Assoc. Prof. Srivieng Pairojkul - Thailand

3. Roundtable Discussion

12:40 PM – 12:50 PM

Prize Presentation for Drawing Competition Winners

12:50 PM – 1:50 PM

Lunch and Poster Competition

1:50 PM – 3:05 PM

Breakout Session 3a
Theme: Shared Decision Making in Serious Illness: Can We Do Better?

1. Understanding CPR as Only Chest Compressions and Rescue Breaths may Facilitate More Patient-Centered Conversations about In-hospital Resuscitation

Theme: Shared Decision Making in Serious illness: Can We Do Better?

1. Understanding CPR as Only Chest Compressions and Rescue Breaths may Facilitate More Patient-Centered Conversations about In-hospital Resuscitation

With the advent of early warning systems improving detection of hospital patients who deteriorate despite active, targeted treatment, cardiopulmonary resuscitation (CPR), is largely unhelpful outside of certain areas such as coronary care units. CPR (most accurately defined as chest compressions and rescue breaths) manually empties the heart, offering a degree of cerebral perfusion whilst the cause of cardiac arrest is reversed. The terms “CPR” and “resuscitation” are often used interchangeably by clinicians and patients. CPR is actually a subset of the broader range of measures that constitute resuscitation. CPR is always a resuscitation measure, but resuscitation is an intent, not a specific treatment.
Clear communication of the reasons for this with patients and families may facilitate better conversations about the optimal care provided to those with serious illness, promoting access to other forms of treatment for patients not suitable for CPR whilst avoiding intrusive CPR at the end of life.

Dr. Tammy Pegg - New Zealand

2. The Fallacy of the Prepared Patient: Ariadne Labs’ Efforts to Scale Serious illness Conversations

Theme: Implementing ACP on Regional and National Levels

2. The Fallacy of the Prepared Patient: Ariadne Labs’ Efforts to Scale Serious illness Conversations

Advance care planning has been criticized recently for a paucity of evidence that it actually improves the quality of care, decision making, or patient/ family/ clinician experience at the end of life. After so much effort for admittedly limited results, why should clinicians, patients & families, investigators, healthcare administrators, and policy makers keep trying to figure out how to make advance care planning bear fruit? This presentation will address the causes, including the fallacy of the prepared patient and the fallacy of training as a driver of practice change. We will also review Ariadne labs’ efforts to drive serious illness conversations at scale using leadership and messaging tactics, practice change strategies, and measuring results to support change, and virtual and simulated approaches to workforce training.

 Assoc. Prof. Erik Fromme - United States

3. mySupport: Nurse-family Led ACP Conversations in Dementia Care

Theme: Shared Decision Making in Serious illness: Can We Do Better?

3. mySupport: Nurse-family Led ACP Conversations in Dementia Care

The 6-country mySupport study implemented advance care planning conversations between trained nursing staff and family caregivers of nursing home residents with advanced dementia. As part of the study, in each country family caregivers received a booklet on palliative care, and a question prompt list to encourage family caregivers to ask questions. We will review types of questions in the different countries, what is known from the literature about effects of question prompt lists as single or as complex interventions, and the impact of the mySupport intervention on decision making.

Assoc. Prof. Jenny van der Steen - The Netherlands

Breakout Session 3b
Theme: ACP Framework, Education and Policy

1. Improving Advance Care Planning Completion Rate for Inpatient Frail Elderly

Theme: ACP Framework, Education and Policy

1. Improving Advance Care Planning Completion Rate for Inpatient Frail Elderly

Dr. Vidhya Dharshini Pillay - Singapore

2. Using A Co-Production Inclusive Approach To Develop A Holistic Advance Care Planning Policy For Adults

Theme: ACP Framework, Education and Policy

2. Using A Co-Production Inclusive Approach To Develop A Holistic Advance Care Planning Policy For Adults

Mrs. Corrina Grimes - United Kingdom

3. Utilizing Simulated Learning to Develop Non-clinical Skills: A Unique Approach to Improving ACP Processes

Theme: ACP Framework, Education and Policy

3. Utilizing Simulated Learning to Develop Non-clinical Skills: A Unique Approach to Improving ACP Processes

Ms. Cari Borenko - Canada

4. Implementing a Shared Goals of Care framework in a large metropolitan hospital in New Zealand

Theme: ACP Framework, Education and Policy

4. Implementing a Shared Goals of Care framework in a large metropolitan hospital in New Zealand

 Dr. Oleg Kiriaev - New Zealand

Breakout Session 3c
Theme: ACP in Nursing Homes

1. Evaluating the Impact of a Virtual Training Programme for ACP Facilitation in Nursing Homes in Singapore

Theme: ACP in Nursing Homes

1. Evaluating the Impact of a Virtual Training Programme for Advance Care Planning Facilitation in Nursing Homes in Singapore

Ms. Sheryl Ng Hui-Xian - Singapore

2. The Potential Contextual Factors and Recommendations for ACP in Long-term Care Facilities in China: A Qualitative Study

Theme: ACP in Nursing Homes

2. The Potential Contextual Factors and Recommendations for ACP in Long-term Care Facilities in China: A Qualitative Study

 Mrs. Yuxin Zhou - United Kingdom

3. Practicing ACP in Nursing Homes in The Netherlands: An Ethnographic Study

Theme: ACP in Nursing Homes

3. Practicing ACP in Nursing Homes in The Netherlands: An Ethnographic Study

 Mrs. Nienke Fleuren -The Netherlands

4. Effectiveness of a Complex ACP Intervention Focusing on Nursing Home Residents: First Results of the Cluster-randomized Controlled BEVOR-trial

Theme: ACP in Nursing Homes

4. Effectiveness of a Complex ACP Intervention Focusing on Nursing Home Residents: First Results of the Cluster-randomized Controlled BEVOR-trial

 Mrs. Kornelia Götze - Germany

3:05 PM – 3:35 PM

Afternoon Tea

3:35 PM – 4:55 PM

Breakout Session 4a
Theme: Community Engagement in ACP

1. Not Done Yet – Designing Better EOL Conversations

Theme: Community Engagement in ACP

1. Not Done Yet – Designing Better EOL Conversations

Not done yet” is a phrase that could mean different things to different people.

To the realist amongst us, “not done yet” is a phrase we will most likely hear when we ask people around us if they have done their ACP. To the optimist, these 3 words means an opportunity to do something that’s not done yet. And lastly, to the seniors and those near their end-of-life journey, “not done yet” could mean there is still time to fulfil their wishes. In this session, we will endeavour to explore all these perspectives of “not done yet” and discover how we may design better end-of-life conversations for the future.

Using insights derived from human-centered approach to our projects in the senior landscape, we will share about how we gained deeper understanding of patients through a combination of gamification and making conversations “intentionally unintentional”.

Mr. Andrew Pang - Singapore
Ms. Jun Lau - Singapore

2. Funeral Planning – Preparing the Unprepared!

Theme: Community Engagement in ACP

2. Funeral Planning – Preparing the Unprepared!

Death is a certainty for everyone. However, no one wants to rush into it. No one also wants to think or talk about it as they are still considered taboo and bad luck. When a death happens – sometimes expectedly through illness, sometimes unexpectedly through traumatic incidents – families are thrown into a whirlwind of grief and emotional stress. Having not told anyone of how we want our funeral to be causes unnecessary tensions and arguments among family members.
Funeral professionals are no strangers to illness and death. We help the community to adopt healthy attitude towards dying, death and funerals. This attitude allows everyone to show love and shared meaning with each other. This presentation focuses on answering this question: How can the funeral profession shift attitudes and promote meaningful conversations about dying, death and funeral?

Mr. Ang Ziqian - Singapore

3. News Media Coverage on End-of-Life Issues and Conversations in Singapore: Implications for Public Health Policy

Theme: Community Engagement in ACP

3. News Media Coverage on End-of-Life Issues and Conversations in Singapore: Implications for Public Health Policy

Singapore’s aging population is increasing at an alarming rate and improving end-of-life (EOL) care is a national imperative. One barrier to receiving quality care is the reluctance to have conversations relating to death. As research has demonstrated the influence of the mass media in driving public discourse to overcome the discomfort of talking about EOL, this paper purposes to uncover Singapore’s mainstream media coverage and the level of emphasis the articles gave to EOL concerns. It content analysed a total of 137 articles trawled over a seven-year period. Findings showed that the media reported heavily on “medical treatment concerns” and “caregiver concerns” and lesser on EOL preparations which are important in driving conversations. The lack of emphasis in media coverage suggests that policy makers and public health communicators should adopt a more holistic perspective to developing communication strategies to better facilitate quality EOL conversations in Singapore.

Mr. Melvin Tan - Singapore

Breakout Session 4b
Theme: ACP in Dementia and Chronic Diseases

1. Concordance between Preferred and Actual Place of Death among Patients with End Stage Renal Disease on Conservative Care in Malaysia

Theme: ACP in Dementia and Chronic Diseases

1. Concordance between Preferred and Actual Place of Death among Patients with End Stage Renal Disease on Conservative Care in Malaysia

 Dr. Wan Jun Ng - Malaysia

2. ACP with a Conversation Game: A Feasibility and Acceptability Study

Theme: ACP in Dementia and Chronic Diseases

2. Advance Care Planning with a Conversation Game: A Feasibility and Acceptability Study

 Assoc. Prof. Christine Clavien - Switzerland

3. A Definitional Framework of ACP in Dementia Achieved a Consensus in a 33-Country Delphi Study

Theme: ACP in Dementia and Chronic Diseases

3. A Definitional Framework of ACP in Dementia Achieved a Consensus in a 33-Country Delphi Study

Assoc. Prof Jenny Van Der Steen - The Netherlands

4. Healthcare Proxy Experiences of ACP by Proxy on behalf of People Without Decision Making Capacity: Pilot Study Results

Theme: ACP in Dementia and Chronic Diseases

4. Healthcare Proxy Experiences of ACP by Proxy on behalf of People Without Decision Making Capacity: Pilot Study Results

Dr. Laura Jones - Switzerland

Breakout Session 4c
Theme: ACP @ Community and in Pandemic Era

1. Associations of Advance Care Plans With End-of-life Healthcare Utilisation of Home Ventilation Patients

Theme: ACP @ Community and in Pandemic Era

1. Associations of Advance Care Plans With End-of-life Healthcare Utilisation of Home Ventilation Patients

Dr. Michelle Pereira - Singapore

2. Evaluation of a Complex ACP Intervention in the General Practice Setting (ACP-GP): Cluster-randomized Controlled Trial

Theme: ACP @ Community and in Pandemic Era

2. Evaluation of a Complex ACP Intervention in the General Practice Setting (ACP-GP): Cluster-randomized Controlled Trial

 Ms. Julie Stevens - Belgium

3. Advance Care Plans: Creation, Content and Use during Wave 1 of the COVID-19 Pandemic

Theme: ACP @ Community and in Pandemic Era

3. Advance Care Plans: Creation, Content and Use during Wave 1 of the COVID-19 Pandemic

 Dr. Philippa McFarlane - United Kingdom

4. Tele-ACP amidst COVID-19 Pandemic and Beyond

Theme: ACP @ Community and in Pandemic Era

4. Tele-ACP amidst COVID-19 Pandemic and Beyond

 Ms. Tricia Tan - Singapore

5:30 PM – 6:30 PM

ACP-i Society General Assembly

8:30 AM – 9:45 AM

Breakout Session 5a
Theme: Technology and Innovations in ACP

1. Selling Palliative Care Upstream and to the Public: Lessons for ACP

Theme: Technology and Innovations in ACP

1. Selling Palliative Care Upstream and to the Public: Lessons for ACP

A major challenge for ACP is that the public misunderstands what it is, its value, and when to do it. Thinking about ACP often only occurs during a crisis, which is too late. Palliative care has a similar challenge. Palliative care is overly associated with dying and death, something the public wants to avoid until close to death. The Waiting Room Revolution is a social movement, mostly known for its podcast of the same name. The movement has worked to change the perception of palliative care into something that is desirable and hopeful for both patients and families experiencing a life-changing diagnosis. The session will review the story of how the Waiting Room Revolution movement overcame challenges and review the lessons that can be applied to the ACP movement.

Dr. Hsien Seow, Canada

2. Supporting ACP Conversations: an Evaluation of a Web-based Tool for People Living with Dementia and their Family

Theme: Technology and Innovations in ACP

2. Supporting ACP Conversations: an Evaluation of a Web-based Tool for People Living with Dementia and their Family

Advance care planning (ACP) is relevant for people with dementia and their families because when the disease progresses, family often plays a crucial role in decision-making. Websites may support people with dementia and their families in ACP. We developed an ACP website for people with dementia and their family caregivers. We first conducted a needs assessment to determine the website content and format. Next, we developed the website using an iterative, user-centered approach. We found that people with dementia and their caregivers considered information on ACP and guidance on how to start a conversation as essential content for the website. Participants identified a text-to-speech option as an important functionality. Furthermore, guidance on how to start a conversation should be tailored to the user, i.e. person with dementia or family caregiver. We are currently testing the website in a mixed methods evaluation study. Results will be presented during the congress.
Collaborators on this study are: Prof. Dr. Tinne Smets, Fanny Monnet, Prof. Dr. Lara Pivodic, Prof. Dr. Aline De Vleminck, Prof. Dr. Chantal Van Audenhove and Prof. Dr. Lieve Van den Block.

Ms. Charlèss Dupont, Belgium

3. Normalizing ACP Through the Use of Technology

Theme: Technology and Innovations in ACP

3. Normalizing ACP Through the Use of Technology

Technology and online communication tools are becoming an increasingly important part of society’s advance care planning journey. The goal of this session is to review different technological and design driven advance care planning models of delivery. The session will ask participants questions about how similar models might be relevant within each person’s own community, the demographics they serve and the health ecosystems in which they operate in.

A wider exploration around mainstream behaviors, digital assets planning and digital legacy conversations will also take place. The overriding goal of this session is for participants to be empowered when assisting communities with advance care plans activities both on and offline. This includes being able to support people when planning for their online life within a ‘social media will’. Guidance and support around conversational and structural changes within professionals' own practice and places of work will also be explored and provided.

Mr. James Norris, United Kingdom

Breakout Session 5b
Theme: Community Outreach and Engagement

1. Effect of an App for Promoting ACP and Motivating Patients to Write their Advance Directives

Theme: Community Outreach and Engagement

1. Effect of an App for Promoting ACP and Motivating Patients to Write their Advance Directives

 Assoc. Prof. Christine Clavien, Switzerland

2. Cross-sectional Survey of ACP Documentation Attitudes in a Singaporean ACP Roadshow

Theme: Community Outreach and Engagement

2. Cross-sectional Survey of ACP Documentation Attitudes in a Singaporean ACP Roadshow

Mr. Sounak Rana, Singapore

3. Attitudinal Factors involved in Advance Directive Adoption over a four-year period: Evidence from a Population-based Study

Theme: Community Outreach and Engagement

3. Attitudinal Factors involved in Advance Directive Adoption over a four-year period: Evidence from a Population-based Study

Mrs. Sarah Vilpert, Switzerland

4. Information Meetings about End-of-Life Care to Facilitate Advance Care Planning: One-Third of Older People is Interested

Theme: Community Outreach and Engagement

4. Information Meetings about End-of-Life Care to Facilitate Advance Care Planning: One-Third of Older People is Interested

Ms. Tessa D. Bergman, The Netherlands

Breakout Session 5c
Theme: ACP in Special Populations and in Specialty Care Units

1. Preferences and Attitudes Towards Life-Sustaining Treatments of Older Chinese Patients and Their Family Caregivers

Theme: ACP in Special Populations and in Specialty Care Units

1. Preferences and Attitudes Towards Life-Sustaining Treatments of Older Chinese Patients and Their Family Caregivers

Ms. Tingting Zhu - The Netherlands

2. Improving and Sustaining ACP within Oncology Settings: Using the Theoretical Domains Framework to Identify the Barriers and Enablers

Theme: ACP in Special Populations and in Specialty Care Units

2. Improving and Sustaining ACP within Oncology Settings: Using the Theoretical Domains Framework to Identify the Barriers and Enablers

 Dr. Lisa Guccione, Australia

3. FACE-Rare: A Novel Palliative Care Intervention for Family Caregivers of Children Living with a Rare Disease

Theme: ACP in Special Populations and in Specialty Care Units

3. FACE-Rare: A Novel Palliative Care Intervention for Family Caregivers of Children Living with a Rare Disease

 Dr. Maureen Lyon, United States

4. Is ACP Appropriate for Patients in Intensive Care Units? Comparative Perspectives between Japan and UK

Theme: ACP in Special Populations and in Specialty Care Units

4. Is Advance Care Planning Appropriate for Patients in Intensive Care Units? Comparative Perspectives between Japan and UK

 Assoc. Prof. Despoina Anagnostou, Japan

9:45 AM – 10:30 AM

Morning Tea

10:30 AM – 12:55 PM

Plenary 5 : Community Engagement

1. A New Realistic Utopia for the End of Life

Plenary 5 : Community Engagement

1. A New Realistic Utopia for the End of Life

The proposition of the Lancet Commission on the Value of Death is that our relationship with death and dying has become unbalanced and we advocate a rebalancing. The Commission recognises that rebalancing death and dying will depend on changes across “death systems,” the many inter-related social, cultural, economic, religious and political factors that determine how death, dying, and bereavement are understood, experienced and managed.
We intend our report to inspire a collective vision for the future. Our recommendations outline the next steps we would urge policy makers, health and social care systems, civil society and communities to take.

 Dr. Libby Sallnow - United Kingdom

2. Moving Forward, Opportunities for Death Literacy

Plenary 5 : Community Engagement

2. Moving Forward, Opportunities for Death Literacy

Death Literacy describes the knowledge and skills that people need to make it possible to gain access to, understand, and make informed choices about end of life and death care options. People and communities with high levels of death literacy have knowledge about the death system and the ability to put that knowledge into practice. Recent research indicates that personal and family experiences of death and dying are rated as the most influential sources of death literacy, followed by cultural sources (books and films) and then formal organisations such as churches, schools, workplaces. What then, is the connection between advance care planning and death literacy? While community education activities such as end-of-life planning can support the development of death literacy in our communities by providing a gateway for conversations and engagement, what insights and opportunities does death literacy research and practice provide in the development of advance care planning.

 Dr. Kerrie Noonan - Australia

3. The Role of the Arts in Community Engagement in Singapore

Plenary 5 : Community Engagement

3. The Role of the Arts in Community Engagement in Singapore

Both Sides, Now is a decade-long arts-based community engagement project on living well, and leaving well co-presented by ArtsWok Collaborative and Drama Box. Hear from one of the Creative Producers for the project on how it has broadened the space for end-of-life conversations in the heartlands of Singapore, from intimate workshops to large-scale public engagements.

 Ms. Ngiam Su-Lin - Singapore

4. I am an End-of-Life Doula in Singapore

Plenary 5 : Community Engagement

4. I am an End-of-Life Doula in Singapore

Jia Ying is an end-of-life doula in Singapore. She shares her journey of exploration and discovery as she seeks to establish her practice to support individuals and their loved ones in navigating the complexities of life and death.

 Ms. Jia Ying Tay - Singapore

5. What I Learned From Implementing ACP in 5 Countries and Diverse Places in the USA

Plenary 5 : Community Engagement

5. What I Learned From Implementing ACP in 5 Countries and Diverse Places in the USA

When Prof. Hammes initiated the RC program, there was a commonly perceived “truth” that ACP would not work in the local population. The reasons for this skepticism were also common. Prof. Hammes shares his practice wisdom and experience on how ACP in cultural diversity is actually more similar than different, as well as changes needed to occur to make ACP a success.

 Dr. Bernard “Bud” Hammes - United States

12:55 PM – 1:15 PM

Closing

Prize Presentation for Oral Presentation and Poster Competition Winners

7:30 AM – 8:30 AM 

Registration

8:30 AM – 12:30 PM

Pre-Conference
Workshop 1

Venue: Academia

Shared Decision Making in Serious illness

Pre-Conference Workshop 1: Shared Decision Making in Serious illness
Venue: Academia
Address: 20 College Road, Singapore 169856
Room: White Space Conference Room, 2nd Level

Shared decision making in serious illness is foundational for person centered care. Through didactic lectures, facilitated discussions and small group role plays, learn how one can best hold goals of care conversations in serious illness. This workshop is based on the Shared Decision Making in Serious Illness (SDMSI) curriculum of Respecting Choices.

 Dr. James (Jay) Joseph - United States

Pre-Conference
Workshop 2

Venue: KKH

ACP in Paediatrics

Pre-Conference Workshop 2: ACP in Paediatrics
Venue: KK Women’s and Children's Hospital (KKH)
Address: 100 Bukit Timah Rd, Singapore 229899
Room: Women’s Tower 1, Lecture Theatre

Children with serious illness can and should be involved in care planning. This workshop teaches principles of ACP in paediatrics and how one can optimally engage children and parents alike in serious illness conversations.

 Prof. Jenny Hynson - Australia
Assoc Prof. Chan Mei Yoke - Singapore

Pre-Conference
Workshop 3

Venue: NTFGH

Definitions, Priorities and Action: Community Engagement, Compassionate Communities and Death Literacy

Pre-conference Workshop 3: Definitions, Priorities and Action: Community Engagement, Compassionate Communities and Death Literacy
Venue: Ng Teng Fong General Hospital (NTFGH)
Address: 1 Jurong East Street 21, Singapore 609606
Room: Excellence, 1st Level Tower A

Public health approaches to end-of-life care show promise in promoting death literacy and “die-logues”. Learn how one can apply principles of the Compassionate Communities movement to foster community activation and ACP within our local networks.

 Dr. Heather Richardson - United Kingdom
 Prof. Amy Yin Man Chow - Hong Kong
 Dr. Kerrie Noonan - Australia
 Ms. Ngiam Su-Lin - Singapore

Pre-Conference
Workshop 4

Venue: CHI

Ethics in ACP

Pre-Conference Workshop 4: Ethics in ACP
Venue: Centre For HealthCare Innovation (CHI)
Address: 18 Jalan Tan Tock Seng, S308443
Room: : Hall One, 2nd Level

Engaging our patients on what truly matters to them is an imperative in serious illness care. While ACP is at its core, an ethical practice, ethical dilemmas may engender moral distress in practitioners. Through real life case examples, this workshop illustrates decision making approaches in such dilemmas.

 Mr. Bernard “Bud” Hammes - United States
 Dr. Esther Ho Peiying - Singapore

12:30 PM – 1:30 PM

Lunch

7:30 AM – 8:30 AM

Registration – Day 1 

8:30 AM – 8:35 AM 

Introductory Videos

8:35 AM – 8:40 AM 

Welcome Address by AIC CEO

8:40 AM – 9:00 AM 

Opening Address by GOH

9:00 AM – 9:30 AM 

Keynote 1:

A Partnership between Professionals and the Public: A New Starting Point for ACP

Keynote 1: A Partnership between Professionals and the Public: A New Starting Point for Advance Care Planning (ACP)

ACP has historically been a professional activity – initiated, led and reported by clinical and other practitioners who take responsibility for discussing future plans with individuals deemed to be approaching the end of life, then disseminating their detail to colleagues who might need to act on the plans.

There is good evidence in the UK that despite best efforts on the part of professionals this approach has limited success. People often fail to appreciate or take advantage of the opportunities of ACP with consequences for their experience of dying and loss on the part of those close to them.

This presentation proposes a new starting point and alternative foci of effort.  It invites community members and groups to become active participants in ACP including its initiation and enactment. It calls for partnership working between the public and professionals related to behaviour change and accountability key to success.  Shared death literacy is a vital element

 Dr Heather Richardson - United Kingdom

9:30 AM – 11:00 AM 

Plenary 1 : ACP and Culture

1. Acculturating to Advance Care Planning

Plenary 1: ACP and Culture

1. Acculturating to Advance Care Planning

Effective advance care planning requires thoughtful consideration of culture, as ACP brokers the exchange of individual values, goals, preferences with the resources of the healthcare system. In this plenary, we explore core elements of intercultural health communication to contextualize advance care planning to cultural norms and healthcare ideals across international settings.  

 Dr. Jia Zhimeng - Canada

2. The Role of Religiosity and Spirituality in ACP: How to Navigate ACP Among Devout Populations

Plenary 1: ACP and Culture

2. The Role of Religiosity and Spirituality in ACP: How to Navigate ACP Among Devout Populations

In many cultures, religion and spirituality are key drivers shaping our deeply held values which further influence their decision-making, including ACP. Evidence showed that strong religiosity (self-perceived importance of religion) is often associated with low engagement in advance care planning. This session will dive into the role of religiosity and spirituality in ACP and how to navigate ACP among religiously devout patients and family members.

 Dr. Diah Martina - Indonesia/ Netherlands

3. Participatory Action Research to Foster “Die-logues” and Organic Conversations on ACP

Plenary 1: ACP and Culture

3. Participatory Action Research to Foster “Die-logues” and Organic Conversations on Advance Care Planning

Participatory action research (PAR) is an approach to empirical investigation that empowers everyday people to critically examine their own lived experience, understand the communal challenge that they face, and become change agents in solving their own problems. It is social change-oriented research that foster collaboration, reflectivity, and emancipation. Using an example of a randomized control trial of the Family Dignity Intervention, this presentation will illustrate how PAR may lead to organic end-of-life discussions in the community.

Dr. Andy Hau Yan Ho - Singapore

11:00 AM – 11:30 AM

Morning Tea – Day 1

11:30 AM – 1:50 PM

Plenary 2 : Evaluation of ACP Outcomes

1. The Evolution of Advance Care Planning

Plenary 2 : Evaluation of ACP Outcomes

1. The Evolution of Advance Care Planning

The practice of advance care planning (ACP) has evolved from a narrow focus on forms to a continuum of care planning focused on preparing people and their surrogate decision makers for communication and medical decision-making. To move ACP clinical care and research forward, we must reconceptualize care planning as a holistic, ongoing process over the life course that includes both tailored in-the-moment and advance decisions at every life stage. This new way of thinking about ACP will require a systems-level approach using evidenced-based methods of implementation science and human factors engineering as well as the inclusion of diverse communities and interdisciplinary experts to develop and evaluate processes to support the continuum of care planning in real world settings.

 Dr. Susan Hickman - United States

2. Implementing Advance Care Planning in Acute Hospitals: Early Lessons and Outcomes

Plenary 2 : Evaluation of ACP Outcomes

2. Implementing Advance Care Planning in Acute Hospitals: Early Lessons and Outcomes

The national Advance Care Planning (ACP) program in Singapore was started in 2011 and is modelled after the Respecting Choices paradigm. We will discuss the key findings and lessons from an early evaluation of the program, and the need for a transformational of cultural, health systems, and behavioural norms to sustain its practice in acute care settings. To assess the progress and success of ACP, we need to establish patient-centred and policy-relevant outcome measures. Challenges faced in the choice, measurement, and interpretation of outcomes included in our evaluation, will be discussed.

Prof. Tan Woan Shin - Singapore

3. Complexity of Implementing a National ACP Program: Experiences from Singapore

Plenary 2 : Evaluation of ACP Outcomes

3. Complexity of Implementing a National Advance Care Planning Program: Experiences from Singapore

The implementation of advance care planning (ACP) is complex. In this talk, I will share the learnings from the evaluation of the second phase of the Singapore’s national ACP program. Findings provided an insight into the multiple health care system challenges that ACP programs face. To integrate ACP within routine clinical care, ACP processes should be simplified, training framework be strengthened, physicians be engaged and an ACP supportive culture be created within and outside organisations. The purpose of ACP needs to be carefully rethought, and appropriate monitoring and evaluation indicators be accordingly agreed upon.

 Dr. Chetna Malhotra - Singapore

4. Evaluation of Care Consistency with Care Preferences: Lessons from the German BEVOR Trial

Plenary 2 : Evaluation of ACP Outcomes

4. Evaluation of Care Consistency with Care Preferences: Lessons from the German BEVOR Trial

Care consistent with care preferences for patients incapable of decision-making is often referred to as the central goal of ACP. Evaluation of goal achievement, however, remains methodologically challenging. In the German BEVOR trial, we developed an instrument to measure retrospectively whether care delivered was consistent with care preferences (3CP) in nursing home (NH) residents.

Firstly, we identified all potentially life-threatening events and related treatment decisions in the past three months from the NH records. We then assessed 3CP based on four different sources: NH records and interviews with resident (if possible), surrogate and nurse. 3CP was evaluated on two levels: (1) apparent consent/refusal (versus preferences unknown), and if known (2) quality of the underlying shared decision-making (SDM) process based on central SDM elements: information about medical situation and options, deliberation and supported choice of treatment. Looking forward to sharing and discussing our experiences in developing and applying the 3CP instrument.

Prof. Georg Marckmann - Germany

5. Improving the Quality and Effectiveness of ACP Conversations through Conversation Analysis

Plenary 2 : Evaluation of ACP Outcomes

5. Improving the Quality and Effectiveness of ACP Conversations through Conversation Analysis

Good conversations clarify and connect people’s true values and preferences with the care they receive. Conversation analysis is an approach to the study of social interaction, verbal and non-verbal, in situations of everyday life. It can lend insights to promoting better quality ACP.

Dr. Luke Kang Kwong - Singapore

1:50 PM – 2:50 PM

Lunch – Day 1

2:50 PM – 4:05 PM

Breakout Session 1a
Theme: Implementing ACP on Regional and National Levels

1. A Whole-System Population Approach to ACP in End-of-Life Care, Using the UK’s Gold Standards Framework.

Theme: Implementing ACP on Regional and National Levels

1. A Whole-System Population-based Approach to Advance Care Planning for Proactive, Personalised Palliative/End-of-Life Care, using the UK’s Gold Standards Framework.

Advance Care Planning (ACP) benefits everyone, particularly people in their final years of life, navigating between different sectors, systems and care-providers. Can whole-system public-health approaches reduce the current lottery of care? Gold Standards Framework (GSF) is an evidence-based, quality improvement end-of-life care (EOLC) programme, used for 25 years across the UK, involving thousands of generalist frontline health/social care teams in different settings -primary care, hospitals, nursing homes, homecare, hospices, prisons and Integrated care sites. Focusing on enablement, democratising and de-medicalising ACP, GSF helps more proactive, personalised, joined-up EOLC across wider populations.

The synergistic impact of whole-system, population-based thinking in outcomes and culture change, is described -greater than the sum of its parts. Earlier identification registers (proactive care), mainstreaming ACP discussions (personalised care), care aligned to preferences, reducing over-hospitalisation (coordinated, goal-concordant care), can reliably create benefits for more people, health economies and wider populations.

Assoc. Prof. Keri Thomas, United Kingdom

2. Catering for Diverse Needs - Future Care Planning in Wales

Theme: Implementing ACP on Regional and National Levels

2. Catering for Diverse Needs - Future Care Planning in Wales

In Wales, the term ‘future care planning’ was introduced in 2017, to include patients with diminished mental capacity and their significant others. Over the last 5 years, work has been undertaken to create education formats, resources and national documents. Key strategic approaches in Wales with regard to future care planning will be presented, including communication strategies and how different formats can help widen choice. The approach seeks to cater for the disparate need of the Welsh population; there is not merely one format for multiple scenarios, but a choice of approaches, communication strategies and documents to suit bespoke needs.

 Prof. Mark Taubert, United Kingdom

3. Applying Science to Practice – Developing a Quality ACP Framework for Singapore.

Theme: Implementing ACP on Regional and National Levels

3. Applying Science to Practice – Developing a Quality ACP Framework for Singapore.

In this session, the speakers aim to share the background work, which is in-progress, in attempting to develop a national framework and guideline for implementing quality Advance Care Planning (ACP) in Singapore, utilising knowledge translation principle, pioneered by the Knowledge Translation Program (KTP), Unity Health Toronto, under the leadership of Dr Sharon Straus. This sharing will allow participants to appreciate how knowledge translation and implementation science principles can be used to develop and implement new services/programmes/policies/frameworks that are relevant to practice.

Assoc. Prof. James Alvin Low, Singapore
Nongluck ("Nink") Pussayapibul, Singapore

Breakout Session 1b
Theme: ACP and Culture

1. Supporting Clinicians to Adopt a Culturally Considerate Approach to ACP Conversations with Patients

Theme: ACP and Culture

1. Supporting Clinicians to Adopt a Culturally Considerate Approach to ACP Conversations with Patients

Dr. Eman Hassan - Canada

2. Japanese Nurse’s Perspectives about Death and Dying and End of Life Decision Making

Theme: ACP and Culture

2. Japanese Nurse’s Perspectives about Death and Dying and End of Life Decision Making

Ms. Yumi Naito, Japan - Australia

3. My Life Choices Project – Attitudes and Perceptions on ACP among Chinese-speaking Older Australians Living in Sydney

Theme: ACP and Culture

3. My Life Choices Project – Attitudes and Perceptions on ACP among Chinese-speaking Older Australians Living in Sydney

Ms. Ling Yeoh, Australia

4. The Creation of an Easy Read ACP Workbook

Theme: ACP and Culture

4. The Creation of an Easy Read Advance Care Planning Workbook

 Ms. Cari Borenko, Canada

Breakout Session 1c
Theme: Patient Empowerment in ACP

1. Is Self-Efficacy Associated with Readiness to Engage ACP among Medical University Students in Taiwan?

Theme: Patient Empowerment in ACP

1. Is Self-Efficacy Associated with Readiness to Engage ACP among Medical University Students in Taiwan?

Dr. Cheng-Pei Lin, Taiwan

2. The Tripartite Dynamism in Advance Care Planning: from Attitude to Initiation

Theme: Patient Empowerment in ACP

2. The Tripartite Dynamism in Advance Care Planning: from Attitude to Initiation

Ms. Margaret HP Suen, Hong Kong

3. Importance of Health Literacy and Knowledge Regarding Advance Care Planning Among Older Adults in Switzerland

Theme: Patient Empowerment in ACP

3. Importance of Health Literacy and Knowledge Regarding Advance Care Planning Among Older Adults in Switzerland

Mr. Clément Meier, Switzerland

4. Re-thinking ACP with a Life Journey and Asset-Based Approach

Theme: Patient Empowerment in ACP

4. Re-thinking Advance Care Planning with a Life Journey and Asset-Based Approach

Dr. Jessica Simon, Canada

4:05 PM – 4:35 PM

Afternoon Tea – Day 1

4:35 PM – 6:10 PM

Breakout Session 2a
Theme: ACP in Asia

1. ACP in Hong Kong: Shifting from Why to How

Theme: ACP in Asia

1. ACP in Hong Kong: Shifting from Why to How

The importance of ACP has gained recognition in Hong Kong over the last two decades. Research evidence has shown that various ACP programmes are well received by care recipients and family caregivers across hospitals, community care, home care services and residential care homes. Given a new advance directive bill is in the pipeline, it is timely to devise a systematic approach for the delivery of ACP services. This presentation will review the current service development, identify challenges that might threaten its sustainability, and discuss various means and strategies to cultivate a conducive environment for ACP implementation.

Prof. Helen Chan - Hong Kong

2. ACP Development in South Korea

Theme: ACP in Asia

2. ACP Development in South Korea

In Asian countries, including Korea, the autonomy associated with the end of life was not as guaranteed as in Western countries. In the past, it was often determined by children who had economic and cultural initiatives in the home, especially if their parents had terminal illness. These cultures have been widespread not only in the hospice-palliative area but also acute care setting until recently but some consensus about life sustaining treatment and patient autonomy was formed due to several historical events. After these series of events, we felt the necessity of legislation related to life-sustaining treatment and had discussed for this issue since 2010. As a result, ‘the Act on decisions on life-sustaining treatment for patients in hospice and palliative care or at the end of life’ (Act No. 14013) was announced in March of 2016 and this Act enforced in February in 2018. Now, personal autonomy is respected for legal reasons at least. However, these autonomy is still in the very early stages, and there seems to be a cultural and social need to mature. In addition, further medical research related to patient autonomy is likely to be needed.

Prof. Sun-Hyun Kim - South Korea

3. ACP in Indonesia: The Interface of Culture and Religion

Theme: ACP in Asia

3. ACP in Indonesia: The Interface of Culture & Religion

Indonesia is a lower-middle-income country and the fourth most populated nation in the world. Like many other Asian countries, Indonesia is also highly collectivist. In addition, Indonesia has the largest Islamic population in the world and is one of the most religious countries worldwide, where faith drives many aspects of life, including healthcare decision-making and ACP. The presentation will describe research findings on the practice of ACP among cancer survivors in Indonesia and how it is influenced by the perspectives on ACP among Indonesian patients, family members, and healthcare professionals. The talk will also review the research findings of perceived barriers and facilitators to the practice of ACP in Indonesia.

Dr. Diah Martina - Indonesia

4. The Advance Care Planning Development in Taiwan: Past, Present, and Future

Theme: ACP in Asia

4. The Advance Care Planning Development in Taiwan: Past, Present, and Future

This presentation will start with a case study regarding decision-making dilemma on life-sustaining treatment for patients and their family members. Two relevant legislations (i.e. Hospice and Palliative Care Act and Patient Right to Autonomy Act) will be introduced to elaborate the case study with possible options for medical decision-making. Then social movement for patient autonomy enlightening by the practice challenges, and the advance care planning (ACP) development will be shared. The current implementation of ACP and public propaganda to facilitate ACP at different levels (i.e. system level, organizational level, and individual level) will also be reported with reflections and future implications.

Dr. Cheng-Pei Lin - Taiwan

Breakout Session 2b
Theme: ACP and Culture

1. The Role of Acculturation in the Process of ACP Among Chinese Immigrants: A Narrative Systematic Review

Theme: ACP and Culture

1. The Role of Acculturation in the Process of ACP Among Chinese Immigrants: A Narrative Systematic Review

Ms. Tingting Zhu - The Netherlands

2. Advance Care Planning Among Older Adults of Moroccan Origin: An Interview-Based Study

Theme: ACP and Culture

2. Advance Care Planning Among Older Adults of Moroccan Origin: An Interview-Based Study

Dr. Hakki Demirkapu - Belgium

3. Developing a Culturally Appropriate ACP Program in Long-term Care Facilities in China: Stakeholder Theory of Change Workshops

Theme: ACP and Culture

3. Developing a Culturally Appropriate ACP Program in Long-term Care Facilities in China: Stakeholder Theory of Change Workshops

Mrs. Yuxin Zhou - United Kingdom

4. Advance Care Planning- type Behaviours in Older non-native Language Speakers in Switzerland

Theme: ACP and Culture

4. Advance Care Planning- type Behaviours in Older non-native Language Speakers in Switzerland

Dr. Laura Jones - Switzerland

Breakout Session 2c
Theme: Programme Development and Evaluation

1. What Makes ACP Effective? Necessary Elements Determined by a Theory of Change

Theme: Programme Development and Evaluation

1. What Makes ACP Effective? Necessary Elements Determined by a Theory of Change

Prof. Berend Feddersen - Germany

2. Facilitators and Barriers to Stakeholder Engagement in ACP for Older Adults in Community Settings: A Mixed-research Systematic Review

Theme: Programme Development and Evaluation

2. Facilitators and Barriers to Stakeholder Engagement in ACP for Older Adults in Community Settings: A Mixed-research Systematic Review

Ms. Monika Pilch - Ireland

3. A Provincial Whole-systems Approach to Promoting Conversations that Matter

Theme: Programme Development and Evaluation

3. A Provincial Whole-systems Approach to Promoting Conversations that Matter

Dr. Eman Hassan - Canada

7:30 AM – 8:30 AM 

Registration – Day 2

8:30 AM – 9:00 AM 

Keynote 2:

Theory-informed, Tiered and Multistage Holistic Advance Care Planning Model

Keynote 2: Theory-informed, Tiered and Multistage Holistic Advance Care Planning Model

Advance Care Planning (ACP) has been taken as a “one-size-fits-all” intervention for all, but readiness in ACP and the health status of the person concerned are found to influence the content and strategies of ACP. Integrating the Transtheoretical Model (TTM) on health-related behaviors and classification of disease prevention model in Public Health, a tiered and multistage model of ACP is developed. This presentation will outline this model and its practices with Chinese Persons in Hong Kong.

 Prof. Amy Chow - Hong Kong

9:00 AM – 10:50 AM 

Plenary 3 : ACP in Special Populations

1. Upholding Personhood with ACP in Dementia

Plenary 3: ACP in Special Populations

1. Upholding Personhood with ACP in Dementia

People with dementia present special challenges in ACP. The key issues that come to mind include mental capacity, the ability and willingness to accept the dementia diagnosis and make plans for the future, and the role of surrogate decision makers. This session will attempt to address these challenges while remaining focused on both the person and the process.

 Prof. Philip Yap Lin Kiat - Singapore

2. Optimising Decision-Making for Seriously Ill Children

Plenary 3: ACP in Special Populations

2. Optimising Decision-Making for Seriously Ill Children

How do we best conceptualise paediatric ACP and what are its potential benefits and limitations? What decision-making approaches for children with life-limiting conditions enable family-centered care? Associate Professor. Jenny Hynson draws upon her life’s work to help us navigate these questions.

 Prof. Jenny Hynson - Australia

3. Nuts and Bolts of Shared Decision Making in Serious illness

Plenary 3: ACP in Special Populations

3. Nuts and Bolts of Shared Decision Making in Serious illness

Shared decision making is a process in which clinicians and patients work together to make treatment decisions in a way that balances clinical evidence on risks and expected outcomes with patient preferences and values. Researchers find enormous gaps between what patients want and what doctors think they want.
Shared decision making requires open and respectful communication between the patient and physician, but myriad factors can undermine this type of exchange. For example, both patient and physician may approach the conversation with pre-conceived notions that hinder the shared decision-making process. This session will review the essential elements that must be present for shared decision making to occur, and strategies to facilitate shared decision making.

 Dr. Carole Montgomery - United States

4. Implementing Shared Decision Making in Serious Illness in a Palliative Care Service in USA

Plenary 3: ACP in Special Populations

4. Implementing Shared Decision Making in Serious Illness in a Palliative Care Service in USA

Person-centered communication (PCC), including advance care planning and shared decision-making in serious illness, is a complex, iterative process which is essential to the delivery of goal-concordant care. Advancing PCC in an American, rural, integrated health system requires identification and mitigation of numerous potential barriers. A “5E” framework was developed and implemented. The 5Es are education, electronic medical record (EMR), engagement, evidence, and execution. During this plenary, participants will hear some of the challenges to advancing PCC and how the 5E framework can help overcome those challenges. Participants will be encouraged to consider how a similar structured approach can help them overcome potential barriers in their settings.

 Dr. James (Jay) Joseph - United States

10:40 AM – 11:20 AM

Morning Tea

11:20 AM – 12:40 PM 

Plenary 4 : ACP Across the World

1. ACP in Japan: Cultural Considerations and the Way Forward

Plenary 4: ACP Across the World

1. ACP in Japan: Cultural Considerations and the Way Forward

Japanese people share some psychocultural-social tendencies that include “surmise,” “self-restraint,” “air,” “peer pressure,” and “community”.

In this context, implicit communication and family-centered decision-making in medicine have been a culturally appropriate practice. In 2018, the Japanese government revised guidelines on end-of-life decision-making and officially introduced the concept of advance care planning (ACP). Since then, awareness of ACP has rapidly increased in and outside of the healthcare system. In this presentation, we will first review the unique psychocultural-social tendencies relevant to ACP in Japan. Second, we will summarize the development and current status of ACP in Japan. Lastly, we will discuss various initiatives to facilitate ACP through patient care, education, research, policy making, and public awareness. To develop and implement culturally appropriate A CP models, further efforts should be made to address how to respect patient preferences through shared decision-making whilst ensuring that family harmony is maintained.

 Dr. Masanori Mori - Japan

2. ACP in Thailand

Plenary 4: ACP Across the World

2. ACP in Thailand

Updates on ACP implementation and practice in Thailand.

 Assoc. Prof. Srivieng Pairojkul - Thailand

3. Roundtable Discussion

12:40 PM – 12:50 PM

Prize Presentation for Drawing Competition Winners

12:50 PM – 1:50 PM

Lunch and Poster Competition

1:50 PM – 3:05 PM

Breakout Session 3a
Theme: Shared Decision Making in Serious Illness: Can We Do Better?

1. Understanding CPR as Only Chest Compressions and Rescue Breaths may Facilitate More Patient-Centered Conversations about In-hospital Resuscitation

Theme: Shared Decision Making in Serious illness: Can We Do Better?

1. Understanding CPR as Only Chest Compressions and Rescue Breaths may Facilitate More Patient-Centered Conversations about In-hospital Resuscitation

With the advent of early warning systems improving detection of hospital patients who deteriorate despite active, targeted treatment, cardiopulmonary resuscitation (CPR), is largely unhelpful outside of certain areas such as coronary care units. CPR (most accurately defined as chest compressions and rescue breaths) manually empties the heart, offering a degree of cerebral perfusion whilst the cause of cardiac arrest is reversed. The terms “CPR” and “resuscitation” are often used interchangeably by clinicians and patients. CPR is actually a subset of the broader range of measures that constitute resuscitation. CPR is always a resuscitation measure, but resuscitation is an intent, not a specific treatment.
Clear communication of the reasons for this with patients and families may facilitate better conversations about the optimal care provided to those with serious illness, promoting access to other forms of treatment for patients not suitable for CPR whilst avoiding intrusive CPR at the end of life.

Dr. Tammy Pegg, New Zealand

2. The Fallacy of the Prepared Patient: Ariadne Labs’ Efforts to Scale Serious illness Conversations

Theme: Implementing ACP on Regional and National Levels

2. The Fallacy of the Prepared Patient: Ariadne Labs’ Efforts to Scale Serious illness Conversations

Advance care planning has been criticized recently for a paucity of evidence that it actually improves the quality of care, decision making, or patient/ family/ clinician experience at the end of life. After so much effort for admittedly limited results, why should clinicians, patients & families, investigators, healthcare administrators, and policy makers keep trying to figure out how to make advance care planning bear fruit? This presentation will address the causes, including the fallacy of the prepared patient and the fallacy of training as a driver of practice change. We will also review Ariadne labs’ efforts to drive serious illness conversations at scale using leadership and messaging tactics, practice change strategies, and measuring results to support change, and virtual and simulated approaches to workforce training.

 Assoc. Prof. Erik Fromme, United States

3. mySupport: Nurse-family Led ACP Conversations in Dementia Care

Theme: Shared Decision Making in Serious illness: Can We Do Better?

3. mySupport: Nurse-family Led ACP Conversations in Dementia Care

The 6-country mySupport study implemented advance care planning conversations between trained nursing staff and family caregivers of nursing home residents with advanced dementia. As part of the study, in each country family caregivers received a booklet on palliative care, and a question prompt list to encourage family caregivers to ask questions. We will review types of questions in the different countries, what is known from the literature about effects of question prompt lists as single or as complex interventions, and the impact of the mySupport intervention on decision making.

Assoc. Prof. Jenny van der Steen, The Netherlands

Breakout Session 3b
Theme: ACP Framework, Education and Policy

1. Improving Advance Care Planning Completion Rate for Inpatient Frail Elderly

Theme: ACP Framework, Education and Policy

1. Improving Advance Care Planning Completion Rate for Inpatient Frail Elderly

 Dr. Vidhya Dharshini Pillay - Singapore

2. Using A Co-Production Inclusive Approach To Develop A Holistic Advance Care Planning Policy For Adults

Theme: ACP Framework, Education and Policy

2. Using A Co-Production Inclusive Approach To Develop A Holistic Advance Care Planning Policy For Adults

Mrs. Corrina Grimes - United Kingdom

3. Utilizing Simulated Learning to Develop Non-clinical Skills: A Unique Approach to Improving ACP Processes

Theme: ACP Framework, Education and Policy

3. Utilizing Simulated Learning to Develop Non-clinical Skills: A Unique Approach to Improving ACP Processes

Ms. Cari Borenko - Canada

4. Implementing a Shared Goals of Care framework in a large metropolitan hospital in New Zealand

Theme: ACP Framework, Education and Policy

4. Implementing a Shared Goals of Care framework in a large metropolitan hospital in New Zealand

 Dr. Oleg Kiriaev - New Zealand

Breakout Session 3c
Theme: ACP in Nursing Homes

1. Evaluating the Impact of a Virtual Training Programme for ACP Facilitation in Nursing Homes in Singapore

Theme: ACP in Nursing Homes

1. Evaluating the Impact of a Virtual Training Programme for Advance Care Planning Facilitation in Nursing Homes in Singapore

Ms. Sheryl Ng Hui-Xian - Singapore

2. The Potential Contextual Factors and Recommendations for ACP in Long-term Care Facilities in China: A Qualitative Study

Theme: ACP in Nursing Homes

2. The Potential Contextual Factors and Recommendations for ACP in Long-term Care Facilities in China: A Qualitative Study

 Mrs. Yuxin Zhou - United Kingdom

3. Practicing ACP in Nursing Homes in The Netherlands: An Ethnographic Study

Theme: ACP in Nursing Homes

3. Practicing ACP in Nursing Homes in The Netherlands: An Ethnographic Study

 Mrs. Nienke Fleuren - Netherlands

4. Effectiveness of a Complex ACP Intervention Focusing on Nursing Home Residents: First Results of the Cluster-randomized Controlled BEVOR-trial

Theme: ACP in Nursing Homes

4. Effectiveness of a Complex ACP Intervention Focusing on Nursing Home Residents: First Results of the Cluster-randomized Controlled BEVOR-trial

 Mrs. Kornelia Götze - Germany

3:05 PM – 3:35 PM

Afternoon Tea

3:35 PM – 4:55 PM

Breakout Session 4a
Theme: Community Engagement in ACP

1. Not Done Yet – Designing Better EOL Conversations

Theme: Community Engagement in ACP

1. Not Done Yet – Designing Better EOL Conversations

Not done yet” is a phrase that could mean different things to different people.

To the realist amongst us, “not done yet” is a phrase we will most likely hear when we ask people around us if they have done their ACP. To the optimist, these 3 words means an opportunity to do something that’s not done yet. And lastly, to the seniors and those near their end-of-life journey, “not done yet” could mean there is still time to fulfil their wishes. In this session, we will endeavour to explore all these perspectives of “not done yet” and discover how we may design better end-of-life conversations for the future.

Using insights derived from human-centered approach to our projects in the senior landscape, we will share about how we gained deeper understanding of patients through a combination of gamification and making conversations “intentionally unintentional”.

Mr. Andrew Pang - Singapore
Ms. Jun Lau - Singapore

2. Funeral Planning – Preparing the Unprepared!

Theme: Community Engagement in ACP

2. Funeral Planning – Preparing the Unprepared!

Death is a certainty for everyone. However, no one wants to rush into it. No one also wants to think or talk about it as they are still considered taboo and bad luck. When a death happens – sometimes expectedly through illness, sometimes unexpectedly through traumatic incidents – families are thrown into a whirlwind of grief and emotional stress. Having not told anyone of how we want our funeral to be causes unnecessary tensions and arguments among family members.
Funeral professionals are no strangers to illness and death. We help the community to adopt healthy attitude towards dying, death and funerals. This attitude allows everyone to show love and shared meaning with each other. This presentation focuses on answering this question: How can the funeral profession shift attitudes and promote meaningful conversations about dying, death and funeral?

Mr. Ang Ziqian - Singapore

3. News Media Coverage on End-of-Life Issues and Conversations in Singapore: Implications for Public Health Policy

Theme: Community Engagement in ACP

3 News Media Coverage on End-of-Life Issues and Conversations in Singapore: Implications for Public Health Policy

Singapore’s aging population is increasing at an alarming rate and improving end-of-life (EOL) care is a national imperative. One barrier to receiving quality care is the reluctance to have conversations relating to death. As research has demonstrated the influence of the mass media in driving public discourse to overcome the discomfort of talking about EOL, this paper purposes to uncover Singapore’s mainstream media coverage and the level of emphasis the articles gave to EOL concerns. It content analysed a total of 137 articles trawled over a seven-year period. Findings showed that the media reported heavily on “medical treatment concerns” and “caregiver concerns” and lesser on EOL preparations which are important in driving conversations. The lack of emphasis in media coverage suggests that policy makers and public health communicators should adopt a more holistic perspective to developing communication strategies to better facilitate quality EOL conversations in Singapore.

Mr. Melvin Tan - Singapore

Breakout Session 4b
Theme: ACP in Dementia and Chronic Diseases

1. Concordance between Preferred and Actual Place of Death among Patients with End Stage Renal Disease on Conservative Care in Malaysia

Theme: ACP in Dementia and Chronic Diseases

1. Concordance between Preferred and Actual Place of Death among Patients with End Stage Renal Disease on Conservative Care in Malaysia

 Dr. Wan Jun Ng - Malaysia

2. ACP with a Conversation Game: A Feasibility and Acceptability Study

Theme: ACP in Dementia and Chronic Diseases

2. Advance Care Planning with a Conversation Game: A Feasibility and Acceptability Study

 Assoc. Prof. Christine Clavien - Switzerland

3. A Definitional Framework of ACP in Dementia Achieved a Consensus in a 33-Country Delphi Study

Theme: ACP in Dementia and Chronic Diseases

3. A Definitional Framework of ACP in Dementia Achieved a Consensus in a 33-Country Delphi Study

Assoc. Prof Jenny Van Der Steen - The Netherlands

4. Healthcare Proxy Experiences of ACP by Proxy on behalf of People Without Decision Making Capacity: Pilot Study Results

Theme: ACP in Dementia and Chronic Diseases

4. Healthcare Proxy Experiences of ACP by Proxy on behalf of People Without Decision Making Capacity: Pilot Study Results

Dr. Laura Jones - Switzerland

Breakout Session 4c
Theme: ACP @ Community and in Pandemic Era

1. Associations of Advance Care Plans With End-of-life Healthcare Utilisation of Home Ventilation Patients

Theme: ACP @ Community and in Pandemic Era

1. Associations of Advance Care Plans With End-of-life Healthcare Utilisation of Home Ventilation Patients

Dr. Michelle Pereira - Singapore

2. Evaluation of a Complex ACP Intervention in the General Practice Setting (ACP-GP): Cluster-randomized Controlled Trial

Theme: ACP @ Community and in Pandemic Era

2. Evaluation of a Complex ACP Intervention in the General Practice Setting (ACP-GP): Cluster-randomized Controlled Trial

 Ms. Julie Stevens - Belgium

3. Advance Care Plans: Creation, Content and Use during Wave 1 of the COVID-19 Pandemic

Theme: ACP @ Community and in Pandemic Era

3. Advance Care Plans: Creation, Content and Use during Wave 1 of the COVID-19 Pandemic

 Dr. Philippa McFarlane - United Kingdom

4. Tele-ACP amidst COVID-19 Pandemic and Beyond

Theme: ACP @ Community and in Pandemic Era

4. Tele-ACP amidst COVID-19 Pandemic and Beyond

 Ms. Tricia Tan - Singapore

5:30 PM – 6:30 PM

ACP-i Society General Assembly

8:30 AM – 9:45 AM

Breakout Session 5a
Theme: Technology and Innovations in ACP

1. Selling Palliative Care Upstream and to the Public: Lessons for ACP

Theme: Technology and Innovations in ACP

1. Selling Palliative Care Upstream and to the Public: Lessons for ACP

A major challenge for ACP is that the public misunderstands what it is, its value, and when to do it. Thinking about ACP often only occurs during a crisis, which is too late. Palliative care has a similar challenge. Palliative care is overly associated with dying and death, something the public wants to avoid until close to death. The Waiting Room Revolution is a social movement, mostly known for its podcast of the same name. The movement has worked to change the perception of palliative care into something that is desirable and hopeful for both patients and families experiencing a life-changing diagnosis. The session will review the story of how the Waiting Room Revolution movement overcame challenges and review the lessons that can be applied to the ACP movement.

Dr. Hsien Seow, Canada

2. Supporting ACP Conversations: an Evaluation of a Web-based Tool for People Living with Dementia and their Family

Theme: Technology and Innovations in ACP

2. Supporting ACP Conversations: an Evaluation of a Web-based Tool for People Living with Dementia and their Family

Advance care planning (ACP) is relevant for people with dementia and their families because when the disease progresses, family often plays a crucial role in decision-making. Websites may support people with dementia and their families in ACP. We developed an ACP website for people with dementia and their family caregivers. We first conducted a needs assessment to determine the website content and format. Next, we developed the website using an iterative, user-centered approach. We found that people with dementia and their caregivers considered information on ACP and guidance on how to start a conversation as essential content for the website. Participants identified a text-to-speech option as an important functionality. Furthermore, guidance on how to start a conversation should be tailored to the user, i.e. person with dementia or family caregiver. We are currently testing the website in a mixed methods evaluation study. Results will be presented during the congress.
Collaborators on this study are: Prof. Dr. Tinne Smets, Fanny Monnet, Prof. Dr. Lara Pivodic, Prof. Dr. Aline De Vleminck, Prof. Dr. Chantal Van Audenhove and Prof. Dr. Lieve Van den Block.

Ms. Charlèss Dupont, Belgium

3. Normalizing ACP Through the Use of Technology

Theme: Technology and Innovations in ACP

3. Normalizing ACP Through the Use of Technology

Technology and online communication tools are becoming an increasingly important part of society’s advance care planning journey. The goal of this session is to review different technological and design driven advance care planning models of delivery. The session will ask participants questions about how similar models might be relevant within each person’s own community, the demographics they serve and the health ecosystems in which they operate in.

A wider exploration around mainstream behaviors, digital assets planning and digital legacy conversations will also take place. The overriding goal of this session is for participants to be empowered when assisting communities with advance care plans activities both on and offline. This includes being able to support people when planning for their online life within a ‘social media will’. Guidance and support around conversational and structural changes within professionals' own practice and places of work will also be explored and provided.

Mr. James Norris, United Kingdom

Breakout Session 5b
Theme: Community Outreach and Engagement

1. Effect of an App for Promoting ACP and Motivating Patients to Write their Advance Directives

Theme: Community Outreach and Engagement

1. Effect of an App for Promoting ACP and Motivating Patients to Write their Advance Directives

 Assoc. Prof. Christine Clavien, Switzerland

2. Cross-sectional Survey of ACP Documentation Attitudes in a Singaporean ACP Roadshow

Theme: Community Outreach and Engagement

2. Cross-sectional Survey of ACP Documentation Attitudes in a Singaporean ACP Roadshow

Mr. Sounak Rana, Singapore

3. Attitudinal Factors involved in Advance Directive Adoption over a four-year period: Evidence from a Population-based Study

Theme: Community Outreach and Engagement

3. Attitudinal Factors involved in Advance Directive Adoption over a four-year period: Evidence from a Population-based Study

Mrs. Sarah Vilpert, Switzerland

4. Information Meetings about End-of-Life Care to Facilitate Advance Care Planning: One-Third of Older People is Interested

Theme: Community Outreach and Engagement

4. Information Meetings about End-of-Life Care to Facilitate Advance Care Planning: One-Third of Older People is Interested

Ms. Tessa D. Bergman, The Netherlands

Breakout Session 5c
Theme: ACP in Special Populations and in Specialty Care Units

1. Preferences and Attitudes Towards Life-Sustaining Treatments of Older Chinese Patients and Their Family Caregivers

Theme: ACP in Special Populations and in Specialty Care Units

1. Preferences and Attitudes Towards Life-Sustaining Treatments of Older Chinese Patients and Their Family Caregivers

Ms. Tingting Zhu - The Netherlands

2. Improving and Sustaining ACP within Oncology Settings: Using the Theoretical Domains Framework to Identify the Barriers and Enablers

Theme: ACP in Special Populations and in Specialty Care Units

2. Improving and Sustaining ACP within Oncology Settings: Using the Theoretical Domains Framework to Identify the Barriers and Enablers

 Dr. Lisa Guccione, Australia

3. FACE-Rare: A Novel Palliative Care Intervention for Family Caregivers of Children Living with a Rare Disease

Theme: ACP in Special Populations and in Specialty Care Units

3. FACE-Rare: A Novel Palliative Care Intervention for Family Caregivers of Children Living with a Rare Disease

 Dr. Maureen Lyon, United States

4. Is ACP Appropriate for Patients in Intensive Care Units? Comparative Perspectives between Japan and UK

Theme: ACP in Special Populations and in Specialty Care Units

4. Is Advance Care Planning Appropriate for Patients in Intensive Care Units? Comparative Perspectives between Japan and UK

 Assoc. Prof. Despoina Anagnostou, Japan

9:45 AM – 10:30 AM

Morning Tea

10:30 AM – 12:45 PM

Plenary 5 : Community Engagement

1. A New Realistic Utopia for the End of Life

Plenary 5 : Community Engagement

1. A New Realistic Utopia for the End of Life

The proposition of the Lancet Commission on the Value of Death is that our relationship with death and dying has become unbalanced and we advocate a rebalancing. The Commission recognises that rebalancing death and dying will depend on changes across “death systems,” the many inter-related social, cultural, economic, religious and political factors that determine how death, dying, and bereavement are understood, experienced and managed.
We intend our report to inspire a collective vision for the future. Our recommendations outline the next steps we would urge policy makers, health and social care systems, civil society and communities to take.

 Dr. Libby Sallnow - United Kingdom

2. Moving Forward, Opportunities for Death Literacy

Plenary 5 : Community Engagement

2. Moving Forward, Opportunities for Death Literacy

Death Literacy describes the knowledge and skills that people need to make it possible to gain access to, understand, and make informed choices about end of life and death care options. People and communities with high levels of death literacy have knowledge about the death system and the ability to put that knowledge into practice. Recent research indicates that personal and family experiences of death and dying are rated as the most influential sources of death literacy, followed by cultural sources (books and films) and then formal organisations such as churches, schools, workplaces. What then, is the connection between advance care planning and death literacy? While community education activities such as end-of-life planning can support the development of death literacy in our communities by providing a gateway for conversations and engagement, what insights and opportunities does death literacy research and practice provide in the development of advance care planning.

 Dr. Kerrie Noonan - Australia

3. The Role of the Arts in Community Engagement in Singapore

Plenary 5 : Community Engagement

3. The Role of the Arts in Community Engagement in Singapore

Both Sides, Now is a decade-long arts-based community engagement project on living well, and leaving well co-presented by ArtsWok Collaborative and Drama Box. Hear from one of the Creative Producers for the project on how it has broadened the space for end-of-life conversations in the heartlands of Singapore, from intimate workshops to large-scale public engagements.

 Ms. Ngiam Su-Lin - Singapore

4. I am an End-of-Life Doula in Singapore

Plenary 5 : Community Engagement

4. I am an End-of-Life Doula in Singapore

Jia Ying is an end-of-life doula in Singapore. She shares her journey of exploration and discovery as she seeks to establish her practice to support individuals and their loved ones in navigating the complexities of life and death.

 Ms. Jia Ying Tay - Singapore

5. What I Learned From Implementing ACP in 5 Countries and Diverse Places in the USA

Plenary 5 : Community Engagement

5. What I Learned From Implementing ACP in 5 Countries and Diverse Places in the USA

When Prof. Hammes initiated the RC program, there was a commonly perceived “truth” that ACP would not work in the local population. The reasons for this skepticism were also common. Prof. Hammes shares his practice wisdom and experience on how ACP in cultural diversity is actually more similar than different, as well as changes needed to occur to make ACP a success.

 Dr. Bernard “Bud” Hammes - United States

12:45 PM – 1:15 PM

Closing
Prize Presentation for Oral Presentation and Poster Competition Winners