42
Informaciones
Psiquiátricas
2017 - n.º 228
y las familias que se promueve desde la PDA,
porque la comunicación permite tener opor-
tunidades para reconocer sus valores tomar
decisiones coherente con ellos, sobre la uti-
lización de antibióticos y nutrición artificial
en los últimos meses de vida, por ejemplo.
En las personas con una enfermedad mental,
el proceso de la PDA puede mejorar el empo-
deramiento, contribuir a una mejor y mayor
conciencia de enfermedad y convertirse en
una herramienta terapéutica. Actualmente
existe una iniciativa del Gobierno de Cata-
luña que pretende mejorar la atención a las
personas con enfermedades crónicas y de
manera específica a aquellas personas con
una enfermedad en fase avanzada. En el plan
de intervención individualizado y comparti-
do sobre estas personas está prevista la PDA.
Palabras clave:
Planificación de Decisiones
Anticipadas, Final de la vida, Demencia.
Abstract
The current model of care between an in-
dividual with a health problem and a health
care professional is based on informed con-
sent. When a person loses his ability to take
decisions about his health, he cannot parti-
cipate in informed consent. Advance direc-
tive was legally regulated many years ago
in our country. It allows for instructions on
health for use when an individual has lost the
ability to decide. But this legal regulation is
insufficient. Advance Care Planning (ACP) is
defined as a deliberative, structured process
by which a person expresses his values, wis-
hes and preferences and, according to these
and in collaboration with their emotional
environment and health reference team, for-
mulates and plans what type of attention
he would like to receive in a situation of
clinical complexity or serious illness that is
expected as probable within a certain rela-
tively short period of time, or in a situation
of end of life, especially in circumstances
in which the individual is unable to decide.
ACP occurs within a care process, requires
the active participation of the patient / fa-
mily and produces a specific treatment plan,
which may include or not a living will. The
ACP has proved useful to improve patient-
centered care at the end of life, improving
the care process, patient, family and profes-
sional satisfaction and continuity of care.
Advanced-stage dementia must be treated
according to the methodology of care at the
end of life. In clinical practice physicians
consider decision making through discussion
with the patient and families to be of great
importance as promoted by the ACP. Good
communication provides opportunities to re-
cognize the person's values, take coherent
decisions based on them with regard to, for
example, the use of antibiotics and artificial
nutrition in the last months of life. In in-
dividuals suffering from mental illness, the
process of ACP can improve empowerment,
contribute to a better and greater awareness
of the disease and become a therapeutic
tool. Currently, the Government of Catalonia
aims to improve care for people with chronic
diseases and specifically those with advan-
ced disease. The personalized, shared plan
of therapy for these people is contemplated
in the ACP.
Key words:
Advance Care Planning, End of
life, Dementia.
Germán Diestre Ortín
