Advance care planning (ACP) is conceptually defined as a proactive, value-based and anticipatory process. However, in practice, it remains structurally reactive, initiated in response to clinical deterioration or institutional prompts within fragmented care pathways. This conceptual paper examines financial consultation during comparatively healthy stages of life, as an upstream, cross-sector context to foster psychological readiness for ACP and strengthen integrated care.
This paper adopts a conceptual synthesis approach, which differs from a systematic review because its aim is theory-building rather than exhaustive evidence aggregation. Literature was identified through structured Google Scholar searches and cross-referencing of key publications, with a focus on peer-reviewed publications from 2000 onwards supplemented by seminal earlier works. The terms included ACP, integrated care, psychological readiness, financial planning, narrative medicine and cross-sector collaboration. Sources were selected purposively to represent key theoretical frameworks and empirical findings relevant to the proposed argument. I prioritized international consensus statements, systematic reviews and conceptual contributions that illuminate the conditions under which ACP engagement occurs across institutional settings.
Financial consultations routinely address uncertainty – including illness risk, long-term care costs and life-course planning – through non-acute, future-oriented conversations in which clients articulate values, goals and trade-offs. These characteristics mirror key psychological and narrative conditions associated with ACP engagement. Financial consultations may be useful upstream, cross-sector nodes to cultivate preparatory reflection and lower barriers to initiating ACP. This could aid the actual clinical decision-making and documentation which remain health and social care services' responsibility.
This paper reframes ACP as part of broader life planning within integrated care systems, and proposes financial consultations as complementary entry points into cross-sector ACP pathways. By highlighting role differentiation and coordination issues between healthcare professionals, financial advisors, insurers and local care networks, it identifies ethical, professional and policy safeguards needed to support collaboration. In addition, it proposes a model to improve individuals' psychological readiness for engaging in ACP.
