Transcript PowerPoint Slides from the above “Speak UP

Advance Care Planning:
Your Decisions Matter
Expressing wishes for end of
life care is important to people
of all ages from all walks of life.
Images of Death
We often imagine that we will die suddenly… but
most people actually experience a slow, progressive
loss of body function.
Your Decisions Matter
We Anticipate and Plan for
Important Life Events
The process of dying is as natural as the
process of being born.
Pregnancy is a developmental state that
prepares us for birth, dying is a
developmental phase of “undoing” or
“unwinding”.
•Both of these phases take time
•Both have observable changes in the
body
Your Decisions Matter
Do you know what
healthcare treatments
you would and would
not want if you could not
speak for yourself?
Do other people know
what your wishes are?
Your Decisions Matter
Our Objectives for Today
1. Discover the value of advance care planning
2. Learn how to talk about your future healthcare
decisions
3. Understand how to document your healthcare
decisions using health care directives
4. Identify with whom to communicate your
decisions
Your Decisions Matter
Advance Care Planning
Involves:
Learning about treatment options
Thinking about your values
Decide what you want and do not want
Choosing an Agent and talking about your decisions
Documenting your wishes
Your Decisions Matter
Your Rights
You have a right to make your own health care
decisions as long as you have the ability to:
Understand and appreciate the nature and
consequences of a health care decision
Communicate a health care decision
Understand your condition
Karen Quinlan
Your Decisions Matter
Patient Self-Determination Act
You have a right to make your own health care
decisions as long as you have the ability to:
Understand and appreciate the nature and
consequences of a health care decision
Communicate a health care decision
Understand your condition
Your Decisions Matter
Patient Self Determination Act
Death does not need to be resisted by every means.
“
“If I become terminally ill, I ask
that I be told of this so I can
prepare myself for death. I
would like assistance with
contacting my priest/pastor who
will care for my spiritual needs.”
You can refuse medical treatment that only prolongs imminent death.
Your Decisions Matter
Why Plan Ahead?
Unable to speak for yourself
Sudden illness or accidents
Leave a guide for others
Peace of mind for loved ones
Your Decisions Matter
Our lives can change in
an instant…most of us
are not able to predict
when we might near
death.
Questions to Discuss
What do you want and not want at the
end of life?
Who should speak for you?
What are your concerns?
What gives your life the most meaning?
What one thing do you want to be sure
your doctors, family and friends know
about your wishes?
Your Decisions Matter
Take time to
reflect on these
questions.
What are your wishes for
physical, emotional or
spiritual comfort?
Be kept comfortable and minimize pain?
Even if the medication impairs your thinking?
Even if the medication might alter your breathing and shorten
your life?
Preserve life regardless of your physical or mental health?
Make health care decisions with consideration for your religion
and beliefs?
Your Decisions Matter
What are your wishes
related to life support?
If there is no reasonable change to regain your life physically or
mentally?
If you have physical limitations but can relate to family and
friends?
If you cannot relate to family and friends?
If you have brain damage or are in a coma?
If you have confusion or dementia that will not improve?
Your Decisions Matter
What are your wishes about how to live?
Want to be healthy enough to care for yourself?
Want to remain in your own home?
Want to live without being dependent upon
medical treatments to be kept alive?
Want to die naturally without lingering?
Want health care even if it exhausts personal
finances?
Your Decisions Matter
Talking About Your Decisions
Valuable opportunity to
reflect on what’s important
with loved ones
Discussion needs to happen
before a crisis
Can provide comfort to your
loved ones
Is up to YOU to initiate
Your Decisions Matter
Meal time can be a good
time to begin this
conversation with your
family members.
Decisions that your loved
ones may have to make
CPR-Cardiopulmonary
Resuscitation
Artificial Breathing - Ventilator
Life Saving Medications
Artificial Food and Fluids
(feeding tubes)
Kidney Dialysis
Tissue and Organ Donation
Your Decisions Matter
It’s less stressful to think
about these treatments
ahead of time.
Documenting Your Decisions
Health care directives document healthcare decisions
at the end of life-it is a tool to help you think through
and communicate your choices
Gives instructions about aspects of health care
Designate an agent to speak on your behalf when
you are unable to speak for yourself
Can give instructions about other end-of-life
wishes
Your Decisions Matter
Healthcare Power
of Attorney
Document who makes medical decisions about your
healthcare
Authorized to speak ONLY if you can’t
May also be called a:
"healthcare proxy or agent"
“healthcare surrogate”
"durable power of attorney for healthcare"
Your Decisions Matter
Your Healthcare Agent
Is someone who:
You trust
Knows you well
Will advocate in your behalf
Will honor your wishes
Can be anyone over the age of 18
Can be a family member, loved one or
close friend
Your Decisions Matter
Living Will
States what you want and do not want for
medical treatments at the end of life but does
not identify someone to speak on your
behalf
May also be called:
Directive to physicians
Healthcare declaration
Medical directive
Your Decisions Matter
A Health Care Directive may permit
you to do the following…
• State your health goals and values
• State preferences about making an anatomical gift
(organ donation)
• Give instructions about where you want to die
• State funeral arrangement preferences
The Five Wishes document is available
in 26 languages and in Braille.
Important to Know
This is not just an issue for the aging
Your health care directive should reflect your
wishes—only you can write your directive
Lawyers are not needed
Make sure your documents are legally valid in the
state where you reside-a notary or two witnesses
must sign in ND & MN
A Health Care Directive does not expire and can
be updated as needed—review it periodically
Your Decisions Matter
What to do with the written document
Give a copy to:
Keep a copy:
•
•
•
•
•
• Where you live
• To bring with you if you
travel
Your Healthcare Agent
Primary provider (doctor)
Health Care Facility
Close family members
Others to consider:
– Faith community leader
– Attorney
Your Decisions Matter
– Most states have reciprocity
statutes that recognize health
care directives completed in
other states
• For another facility if care is
transferred
When an Health Care Directive is
present, a Health Care Provider must:
Read the document
Validate the content
Respect and follow patient
choices
If unable to follow or carry out,
must provide for transfer of care
to another provider/facility
Your Decisions Matter
Key Points about
Writing an Health Care Directive:
Include your loved ones in the decision—this is a gift
you can give to your family and loved ones
Visit with your primary care provider at your annual
visit
Talk with your faith community leader or a parish
nurse
Don’t wait until you are sick to complete this
important document
Your Decisions Matter
Key Points about
Writing an Health Care Directive:
Make sure it is properly witnessed
Make copies for family or health care agent
Know that it can be changed or revoked at
any time by you
Must be in writing
Your Decisions Matter
What happens if you don’t
have an health care directive?
State law determines who makes decisions when
you cannot speak for yourself
In North Dakota the order is:
Court-appointed guardian or custodian if there is one
Spouse
Children
Parents
Adult brothers and sisters
Grandparents
Adult grandchildren
An adult friend or close relative
Your Decisions Matter
Your decisions matter…
you have choices
Talk to your loved ones
“I learned today that my decisions matter. I want to take this
opportunity to talk with you about my decisions for healthcare if I am ever in
a situation where I can no longer speak for myself.”
Get information that will help you make the best
decisions for you then develop a written health care
directive
Encourage others to document their wishes and talk
with their loved ones too
Your Decisions Matter
Resources That Can Help
Sanford Health
Patient Representative or the House Administrator after 4:30 p.m. or on
weekends
Sanford Health website at www.sanfordhealth.org
Health care Directives Information and forms can be found at
Caring Connections at www.caringinfo.org/stateaddownload/
National Healthcare Decisions Day at
www.nationalhealthcaredecisionsday.org
ND Department of Human Services at http://www.nd.gov/dhs/
MN Department of Health at http://www.health.state.mn.us/
Your Decisions Matter
The art of living well and the art of dying well
are one. Epicarus
The future depends on
what we do in the
present.
–Mahatma Gandhi
Your Decisions Matter