Transcript PLANNING FOR END OF LIFE CARE
PLANNING FOR END OF LIFE CARE learn strategies to support your conversations about end of life care JOIN US MAY 20 2014 6-8pm R.H. MURRAY SCHOOL Whitefish, Ontario Heather Westaway Registered Kinesologist Manager, Health Sciences and Interprofessional Education Northern Ontario School of Medicine [email protected]
Sponsored by the Whitefish District Lions Club Lori Rietze BScN, MSN, PhD (c) Registered Nurse Faculty, Laurentian University [email protected]
http://www.advancecareplanning.ca/health-care-professionals/videos.aspx
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Objectives for tonight: Who will make decisions for me if I am not capable of making them myself?
How will the person making decisions for me know what I would have wanted?
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What is Advance Care Planning?
Why is Advance Care Planning Important?
How do I start Advance Care Planning?
What are Goals of Care? 7.
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How do I start Goals of Care Conversations?
BREAK 9.
What will happen if I don’t have Advance Care Planning discussions with my family, friends and healthcare providers? 10.
Where can I find more information?
Who will make decisions for me if I am not capable of making them myself?
1.Your doctor must inform you that you are not capable of making your own decisions 2. Your doctor must get consent for all treatments from your substitute decision maker
Are you able to understand service the information that is relevant to making a decision about the treatment, admission, or personal assistance The health care provider who proposes a treatment is required to form an opinion about your capacity to provide consent Are you able to appreciate decision.
the reasonably foreseeable consequences of a decision or lack of
Hierarchy of Substitute Decision Makers – HCCA, 1996 1. Guardian of person 2. Attorney in Power of Attorney for Personal Care 3. Representative appointed by Consent and Capacity Board 4. Spouse or partner 5. Child or Parent or CAS (right of custody) 6. Parent with right of access 7. Brother or sister 8. Any other relative 9. Office of the Public Guardian and Trustee
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Requirements to ACT as Substitute Decision Maker
The person highest in the hierarchy may give or refuse consent only if he or she is: a) Capable b) At least 16 years old c) No court order or separation order d) Available e) Willing
“Well then what is a Power of Attorney?”
“A Power of Attorney for Personal Care is a
document
through which you appoint your substitute decision-maker and give them the power to make decisions about all aspects of your personal care… health care, shelter, clothing (etc.)… only used if you become incapable…”
How would the person making decisions for me know what treatments I would have wanted?
Is the treatment likely to improve my condition or well-being?
What are my expressed wishes when I am capable?
Treatment Decision by the Substitute Decision Maker
Expressed Wishes = Advance Care Planning w SDM, when capable, in advance of hospitalization, at home Is the treatment likely to improve my condition or well-being?
Advance care planning can inform Goals of Care Conversations What are my expressed wishes when I am capable?
Treatment Decisions = Goals of Care w doctor in hospital,
in the moment
Treatment Decision by the Substitute Decision Maker
How will I make decisions about my care at End-of-life?
Advance care planning • ongoing process of discussing, formalizing, and updating a person’s preferences and wishes for the end of life • to guide substitute decision makers in making decisions about care should you become incapacitated Goals of Care • consent of particular treatment such as resuscitation or artificial ventilation • with you if you are capable or your substitute decision maker if your are incapable
So, What is Advance Care Planning then
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Advance care planning is ongoing expressions general values and wishes about how you wish to be cared for in the future. These conversations are held between you and your substitute decision maker when you are not in hospital and while you are still capable.
So, What is
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Advance Care Planning then
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• • • • One conversation A consent to treatments (not generally helpful) • A refusal of medical treatments (not generally helpful) A document or checklist to be completed Wishes that are NOT shared with your SDM
Why is Advance Care Planning important?
Benefits of Advance Care Planning
Your wishes are more likely to be respected a sense of control over your treatments Quality of life and death stress on substitute decision maker conflict among your family members and friends Medical over or under treatment (suffering) unwanted hospitalization
How do I start Advance Care Planning?
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So, what are Goals of Care then?
Goals of care conversations are discussions about consent to treatments. These conversations are held between you and your doctor or your substitute decision maker and your doctor when you are in hospital.
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How will I start Goals of Care Conversations?
Make a list of any illnesses that you have (heart failure, dementia, cancer…) Ask your doctor about your illness progression and trajectory Ask your doctor about potential end of life treatments Continue to ask questions about these treatments until you understand your options, risks and benefits Communicate your treatment decisions to your substitute decision maker and your doctor
Wallet card p. 39
Where can I get more Information?
SPEAK UP: www.Advancecareplanning.ca
Advocacy Centre for the Elderly: www.acelaw.ca
Thank you
Judith Wahl, B.A., LL.B for her contribution to the content in this project and for her ongoing support.
The Whitefish District Lions Club
QUESTIONS?