Dignity Plan

Exploring your needs by holistically considering all the aspects of your life

The Family Aged Care Advocates Dignity Plan is the key document for understanding the unique needs of your situation.  From this we are then able to ensure future planning and service provision is tailored to your care needs.  This can become increasingly important when there are many competing needs and limited resources.

Our Dignity Planning session takes a visual, schematic journey through your home and community identifying the challenges and strengths, recognising the really important things that you don’t want to give up.  These are the things that define you.  We also consider broader aspects such as the allocation of the right person, or people, to take on Enduring Guardianship and Enduring Power of Attorney responsibilities. Following the planning session, we will provide you with a comprehensive plan that captures the discussion and prioritises areas of action.  If required, we can also reproduce the plan into a format your chosen provider is comfortable with.

Because life is not static and needs change and evolve, part of our service is checking back in with you to review and update the plan as necessary.  You only need to do the Dignity Plan once, even if you move from one service option to another, for example, moving from home care to residential aged care.  We just update the document as changes in your circumstances are made.  The Dignity Plan is included in our service options because we believe it is a very comprehensive and useful way of defining what is required for your ageing with dignity journey.

What is the difference between the Dignity Plan and the Care Plan that the Home Care provider or GP has?

The Dignity Plan is a detailed document that explores your needs by holistically considering all the aspects of your life allowing you to do what you want and when.  This includes, but not limited to, looking at health and medical needs, activities of daily living, social and community connection and financial and legal considerations.

A care plan from another provider is often more relevant to you for their processes than it is helpful for you as it’s often completed for funding or compliance purposes.  For example, a GP may have several care plans for you, this is how they claim the subsidy from the medical benefits scheme and ensure they have offered relevant service options.  If you have a home care package, you will have a care plan also.  This is required by the home care provider to demonstrate that you are involved in planning your care needs and provides a mechanism to manage spending from the package. Additionally, it is expected of them to meet their compliance requirements.

It is not that they are inferior, they just tend to be “about” you, not “with” you.  The Dignity Plan is your tailored document that helps you plan what you need and when.  It allows you to filter through the various aspects of where you are at now and where you want to be in the future.  It assists us work out where we need to focus, spend resources or what needs to be let go of.

I am looking to move into Residential aged care, why is a Dignity Plan still relevant?

As with home care services, all residents of an aged care residence will have a care plan created when they first move into care.  These plans are created from the various nursing assessments that are undertaken on admission.  Under the new quality standards, there is now an expectation that the resident and their family are involved in this process.  Usually this will either be through a meeting and/or being given the document to review and sign off on.

The Dignity Plan is relevant because it is very much your personalised document that puts your needs in order of priority and perspective.  As residential care moves more to a Consumer Directed Model of care, as home care is, this will become increasingly relevant in giving you a voice and maintaining some control.  It will help ensure that you remain connected with things that are relevant to you.  If you have come into residential care with a plan to use it as a rehabilitative process before moving out again, the Dignity Plan will define what this might look like and again ensure resources can be focused on the end goal.

If, however, this is the final move, the Dignity Plan can assist you and your family in making sure that other very important needs are covered, such as financial and legal requirements, your funeral provider, palliative care and end of life wishes.

What is the difference between the Dignity Plan and an Advanced Care Plan /Directive (ACP/ACD)?

An ACP is a document that identifies what you want, or don’t want, as you move into a palliative phase of your life.  Most residential aged care facilities will require you to complete one on admission.

It is important to note that this is a different document to a “Do Not Resuscitate / Not for Resuscitation” order which is a very brief instruction on whether you want resuscitation measures, such as CPR, performed on you.  This document is commonly requested of you should you have an episode of care in the hospital.  

An ACP is more in-depth than a resuscitation order.  There is no specific template, but they should all ask you to consider things that are tolerable to you and things that are not, such as how you feel about not being able to feed yourself , being  incontinent of urine and faeces or not recognising loved ones, etc.  The question about resuscitation will be covered, but it will also explore concepts around length of life versus quality of life. Understanding that there are many interventions that can be done in many situations, whilst they may prolong your life, it may not be in a way that is tolerable to you.  It is you that knows best what these parameters are, and your health care team/GP are guided by this understanding.

Whilst your Dignity Plan is separate to an ACP, we can add in the ACP to the Dignity Planning session.  In fact, we highly recommend that you do.

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