He mostly kept to himself, tinkering with the various electronic and computer gizmos, the love of which he acquired as a young boy and maintained in a long career as an electrical engineer. He had been close to his sister but she had died, and he did not keep in close contact with his one and only niece, who lived a long way away and had significant health problems of her own.

Harold had a number of medical problems, including high blood pressure, arthritis and prostate enlargement. The two things that bothered him the most were the pains from arthritis, which hindered his independence, and having to get up multiple times at night to go to the toilet, which affected his quality of sleep.

Harold came to see me one day after noticing that he was becoming more forgetful.

He was especially worried with his short-term memory. He was concerned that he might be developing Alzheimer disease, a disease that had affected his late father. A screening test in the form of MMSE suggested early cognitive impairment.

As Harold's GP, I realised the importance of monitoring and managing his multiple chronic diseases, including monitoring his cognitive impairment and putting in strategies to maximise his cognitive function.

But another important aspect of caring for Harold was to discuss his wishes regarding future care, clarifying who would make health care decisions for him if he were to lose decision-making capacity in the future. It was also important to assess his supportive care needs to make sure that our practice is doing everything that we can for him.

And the Advance Project would help us to do exactly that.

Associate Professor Joel Rhee

Like to know more?

Watch a video of Associate Professor Rhee discussing the important role general practices can play in the early identification of palliative care and supportive needs.