Kristel Jogila

Marjana Bernot




Kristel Jogila


North Estonia Medical Center, Tallin








To adapt and to implement an ACP form for patients suffering from incuriable diseases in North Estonia Medical Centre



Achieving a preferred place of death (PPoD) is a quality marker of palliative care. Improvements in knowledge of PPoD and decreasing deaths in hospital have been achieved through advance care planning (ACP) and advance directives.
ACP enables individuals to make plans about their future healthcare. ACP articulates the treatments that an individual would want (or not want) at the end of life such as ventilators, feeding tubes, or cardiopulmonary resuscitation. (reduces use of invasive or futile treatments such as feeding tubes or ventilators)
ACP can improve the quality of patient-clinician communication, reduce unwanted hospitalizations, increase the use of palliative care, and increase patient satisfaction and quality of life.
The person’s will must also be considered when providing healthcare in Estonia. This is also the case when a person incapable for decision-making in a current situation. We do not have a separate patient control regulation, but a person can always write living will.
Council of Europe Committee of Ministers has also given a recommendation that countries should establish regulation of patient ́s health, given the right to self-determination of people.



To adapt and implement ACP form


Methods / process

To find suitable ACP form, translate it into Estonian and test it Follow-up Care Clinic patients. Intended outputs:
• Better outcomes for family members, including reduced decision making burden, and less anxiety and depressive symptoms.
• Patient ́s and family members ́ improved awareness.
• Dying patients ́ wishes are followed like stated in their ACP and they have „good deaths“.
• Reduced end-of-life medical costs for persons who have an advance directive calling for
limited care.