Advance Care Planning: It’s how we care for each · PDF file ·...
Transcript of Advance Care Planning: It’s how we care for each · PDF file ·...
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Advance Care Planning
How many people have heard about ‘advance care planning’?
It’s about having conversations! …About your values and wishes
…About who would speak for you if you couldn’t
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Why Should We Do
Advance Care Planning?
1. Canadians are living longer – but eventually, we all die.
2. Most Canadians die of chronic illnesses – and can live with these illnesses for many years before death.
3. Health care decisions can be complex – they may be easier to think about ahead of time.
4. ACP can ease the burden on loved ones to make decisions when you can’t.
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What We Know
• Advance care planning will:
– Reduce your family’s stress and anxiety.
– Improve your satisfaction with your care.
– Improve your quality of life and quality of death.
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Who Needs to do
Advance Care Planning?
Everyone.
You never know when you may face an
unexpected event or illness and will be unable to make your wishes known.
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Without a conversation…..
“I didn’t expect him to die so soon. My husband resisted
talking about dying and after 40 years of marriage. I feel he
let me down by not opening up and I guess I let him down for
not knowing how to talk about some of the things that I
needed to discuss. It would have been nice closure if things
had been different in the end. I can never get that time back.”
-CANHELP study participant
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Let’s get started…
The Speak Up campaign developed the “5 Steps” of advance care planning.
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How to Begin: The 5 Steps
1. Think about your values/wishes:
what is most important to you
2. Learn about medical information
relevant to your health concerns
(prognosis, benefits/risks, likely
outcomes, end-of-life care)
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How to Begin: The 5 Steps
3. Decide who will be your substitute
decision maker.
4. Talk – with your substitute
decision maker, your loved ones, and health care providers
5. Record your values and wishes.
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Step 1:
Think about Your Values & Beliefs
What makes my life meaningful?
Time with family & friends
My faith
Love for my garden, music,
art, work, hobbies, pet.
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Live independently?
Make my own decisions?
Enjoy a good meal?
Have my privacy upheld?
Recognize or talk with
others?
Step 1:
Think about Your Health
What do I value most, being able to…
How do I feel about being…
Kept alive with machines?
In a coma & not expected
to wake up?
Unable to recover from
permanent & severe brain
damage?
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Step 1:
Think About End of Life
Family and friends nearby
Religious rituals observed
Spiritual/religious leader
An open window
Listen to music I love
Hear people talk about my
life’s happy memories
If I were nearing death, what would I want to make the
end more peaceful for me?
If possible, would I prefer to die…
At home? In a hospice? In the hospital?
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Step 2:
Learn
Learn about information that relevant
to your current health situation.
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Step 2:Learn
If you’re diagnosed with an illness, ask your doctor
questions about what to expect in terms of…
• What your life will look like 6 months / 1 year / 5 years from now
• Odds of recovery picking one course of treatment over another
• Possible big changes in your health to prepare for
• Your ability to function independently
• If you decide against treatment
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Step 3:
Substitute Decision Maker(s)
• Only if you are unable to make decisions yourself,
your healthcare providers will turn to your…
• Substitute Decision Maker(s):
– Make medical decisions on your behalf
– Gives or refuse consent to treatments
– Direct your care and advocate for your wishes,
if you have talked with them!
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Step 3:
Consent & Capacity
• As long as you have capacity health care providers must
ask you for consent or refusal of consent for health care
interventions/treatments
• Capacity to make healthcare decisions means that
– You must be able to understand relevant information.
– You must be able to grasp the likely outcome of a decision.
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Step 3:
How to decide on an SDM(s)
• Who do I trust to make decisions based on my values
and wishes?
• Who is able to communicate clearly?
• Who is willing and available to speak for me?
• Who can make difficult decisions in stressful situations?
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Step 3: Regional Differences
• Legal frameworks regarding substitute decision
makers vary between provinces and territories
• Check www.advancecareplanning.ca to find the
information for your province/territory
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Step 4:
Have the Talk!
Advance care planning means having discussions with your substitute decision maker(s), with family and friends, and your health care team.
Awkward? Maybe.
Important? Definitely!
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Step 5:
Document Your Wishes
You can write your wishes down or
make an audio or video recording
Give copies to:
• Your substitute decision makers
• Your family
• Important friends
• Your healthcare providers
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Step 5:
Remember to Review and Revise
• Review and update your wishes…
– When there are life changes – births, deaths,
marriages, transitions, moves;
– When there is a change in your health status;
– When you change your mind about your preferences;
– When new information is available;
– Annually.
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Advance Care Planning in Canada
• Initiated by the Quality End-of-Life Care Coalition of
Canada & facilitated by the Canadian Hospice Palliative
Care Association
• Overseen by a national Task Group that is
interprofessional and represents many jurisdictions
• Research partnership with CARENET
2525
ACP Day
ACP Day is an annual awareness day to engage
organizations about ACP.
How to participate?
• Toolkit available at www.advancecareplanning.ca
• Contact [email protected]
• Hashtag! #ACPDAY2017 and #mycommunity
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Resources for Prostate Cancer
Patients and Caregivers
Online/print workbooks
Conversation starters
Forums
Videos
Webinars
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Tools for Organizations
• Developed in partnership groups across the country
– To raise awareness
– To provide information
• A wide range of resources
– Posters
– Infographics, Videos
– All available electronically
and in print
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Tools for Professionals:
“Just Ask” Conversation Cards & Guides
• Questions to ask patients
– Have you talked to your SDM (or
anyone else) about your wishes?
– Do you have a living will, advance
directive, or advance care plan?
• Questions to ask yourself
– Did I ask my patient about preferences
for end-of-life care?