Malcolm's anticipatory care

Scene 1

The respiratory nurse sees Malcolm at home. He had an acute exacerbation of his IPF and he was admitted to hospital for three days.  Malcolm says he doesn’t want to go back to hospital if he can avoid it. Anna explains that this is difficult to predict for certain, but that people don’t always regain the same level of function after an exacerbation.

Scene 2

Anna starts a delicate discussion about anticipatory care planning. She asks if Malcolm and Louise have thought about what might happen in the future. By looking ahead and talking to each other openly people often feel more prepared.

Louise admits that she finds it hard to talk to Malcolm about it, as he tends to makes light of it and brushes it off.

Scene 3

Malcolm says he doesn’t want to disappoint Louise by giving up hope, but after being in hospital, he feels he would like to be better prepared for the future. Malcolm says he would like to be at home, but it’s important to him that things are not too difficult for Louise.

He admits he’s scared of feeling so breathless and dependent, the thought of this is making him anxious.

Anna explains that the process of telling others about your wishes is known as anticipatory care plan. This includes making a record of personal care choices or preferences. The ACP is a flexible document and Malcolm can change his mind or add to it at any time.