Table 2 The ACA (availability, current issues, anticipation) checklist
Availability (of the GP for the patient): | |
1. | Taking time |
2. | Allowing any subject to be discussed |
3. | Active listening |
4. | Facilitating behaviour (e.g. empathic, respectful, attentive, occasionally also phoning or visiting the patient spontaneously) |
5. | Shared decision-making with regard to diagnosis and treatment plan |
6. | Accessibility (e.g. phone numbers) |
Current issues (that should be raised by the GP): | |
1. | Diagnosis |
2. | Prognosis |
3. | Patient’s complaints and worries: - physical |
4. | - Psychosocial |
5. | - Spiritual/existential |
6. | Wishes for the present and the coming days |
7. | Unfinished business, bringing life to a close |
8. | Discussing treatment and care options (concerning 1-7) |
Anticipating (various scenarios): | |
1. | Offering follow-up appointments |
2. | Possible complications |
3. | Wishes for the coming weeks/months (personal wishes as well as preferences with regard to medical decisions) |
4. | The actual process of dying (final hours/days) |
5. | End-of-life decisions |