Friday, February 8, 2013

Advance Care Planning

I attended a webinar on Advance Care Planning. It's something many of us do not do.

Advance Care Planning is the process of thinking about your wishes for health care
Your wishes are based on your personal values, desires and discussions with your loved ones. These preferences are not right or wrong - they reflect what is important to you. Your healthcare team will consider your wishes, in conjunction with medically appropriate treatment options, and make a decision regarding your treatment.

Too many cannot bear the thought of death and dying. We fear talking about it.
It is important at end-of-life that family understand where they sit.
A family wants to understand the patient trajectory, and it is up to staff to prepare them for this eventuality.
Whenever I see a news article, I talk to my family about how I would like my care managed.

The professionals want you to know what happens in substitute decision making.
Sit with your loved ones: let them know if you want tubes or not, a DNR order or not.
It can be called a Personal Directive (e.g., Alberta), in the US it is a Living Will.
Think about being in long-term care. Would you want to be transferred, in the eventuality of issues in your home. Some are shuttled off to an ER despite DNRs, and suffer waiting in hallways. Be specific with the situations.

Focus of care
Goals of care - written with doctor or NP, during family meeting, or during a crisis and change in focus of care. Despite this clear purpose, and protocol, not all doctors do this with and for their patients.
The purpose of Advance Care Planning is to prepare for eventualities. Talk to your doctor and your family.
Diagnosis, prognosis, burden of life sustaining comfort measures, resources that exist
Goals of Care Designation = GCD



November 15, 2012 - Sharon Iversen, "Advance Care Planning in Long Term Care Settings" (Click here for the slides) To view the Advance Care Planning Policy discussed in the webinar, please click here.


 

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