Surfing towards death with the patient and your trainees

Helena Karppinen

Keywords: Advance care planning, will-to-live, training for discussions


Most people die in primary care or communities, and the median age at the death is over 86 years. Healthcare costs of the final year of life account for up to a quarter of the lifetime expenditure. If GPs would commence advance care planning and increase the number of living wills, the nearing death might follow the patient preferences - with lower costs.
Many GPs and trainees feel themselves incompetent to start the discussion with their old patients about dying. However, there is nobody who could do it better.


The listeners will experience a short example of the novel educational activity that can be delivered in any GP practice without an expert teacher. This activity to empower health care professionals to start the difficult discussions about the patient preferences is based on research about will-to-live, living wills and attitudes among older home-dwelling people.


Most older people hope that the GP would ask the difficult questions. The GP educators in the audience may find new insight into traditional teaching: their students, trainees or colleagues may learn the most, if they are challenged with their own attitudes towards death, knowing better and teaching themselves.


Self-directed learning in small groups of the workplace is possible, if the structure is simple and easy to follow. Planning the care of the patient in advance (ACP) may be even fun.

Points for discussion:

Is this method of ST or CME feasible in your primary care settings?

Is ACP possible in 10 minutes?


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