Presentation on Think Ahead (at Dublin Community Hospital Network, August 2014) (DCN10)
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Transcript of Presentation on Think Ahead (at Dublin Community Hospital Network, August 2014) (DCN10)
What is Think Ahead?
THINK, TALK, TELL……
• Think Ahead Form: A facility to record your will and preferences in the event of emergency, serious illness or death
…….RECORD, REVIEW
• THINK about how well those close to
you would know or understand your
wishes if a time came when you could
not speak for yourself because of
illness.
• TALK about these wishes with those
close to you and with professionals
such as a GP, solicitor or accountant.
TELL the most relevant people in your
life about your wishes and record them
so that they can be available if at some
stage, for whatever reason, you are
unable to speak for yourself.
• RECORD AND REVIEW
Sections of TA Form
Section 1 – Key Information
Provides key information about you that can inform your treatment and care in an emergency.
Section 2 – Care Preferences
How would you like to be cared for if hospitalised? Are there religious or cultural preferences that staff should consider in caring for you?
Section 3 – Legal
You legal affairs. Will? Enduring Power of Attorney?
Sections of TA Form
Section 4 – Financial
This section makes it easier for your family or executors to arrange your financial affairs after your death.
Section 5 – When I Die
What are your preferences for what happens when you die? Would you like to be an organ donor? What about your funeral or burial?
Section 6 – Sharing of Information
How would you like your information to be shared?
GP Pilot Study
• GP Pilot study was completed by Dr Brendan O’Shea involving four GP practices in Dublin and 100 patients up to 70 years of age. This paper was published in the May 2014 issue of the Irish Medical Journal
• Positive outcomes for Patients and GPs
- 83% of patients reported initiating discussions with family members, and high acceptability to patients (completed some or all of it).
- When asked if they found it to be upsetting to complete, 74% indicated it was not upsetting.
END-OF-LIFE PLANNING NURSING HOMES
• Controlled trial / waiting list / mixed methods
• Educational Intervention using Think Ahead
• 5 Intervention and 3 control Nursing Homes
• Key Outcome – Documentation EoL Planning
Intervention
Interactive NH Workshop, using Think Ahead
Dr Deborah Martin Dr Joe Marry, Dr Hugh Brady, Dr Connor Gallagher, Prof Catherine
Darker
Think Ahead and You
Advance Care Planning
•Positive affect on medical care before death (fewer aggressive interventions, like resuscitation, ventilation)
•Improved quality of life/acceptance for the patient
•Can enable access to palliative care
•Makes the adjustment process better for the surviving caregivers.
What is it?
An advance healthcare directive is a written statement
made by a person with capacity (the ability to
understand information and make decisions) setting out
their preferences about medical treatments that might
be needed at a time when they cannot speak for
themselves.
12 Things You Should Know
1. They are recognised under common law (in the
courts) at the moment, but there has been no
legislation.
2. Under the new law, any adult who has capacity
can prepare an Advance Healthcare Directive.
3. An Advance Healthcare Directive must be in
writing, and must be witnessed.
4. They can be revoked at any time while you have capacity, either verbally or in writing. They can also be amended at any time, but that must be done in writing.
5. No one can be forced to make one. They are not compulsory.
6. The fact it has to be witnessed is geared to prevent people from being forced into a certain decision.
7. You can nominate a person who will be allowed
to speak for you when you lose capacity and
ensure that your wishes are respected.
8. An advance healthcare directive only comes
into force if you lose capacity and cannot make
a decision.
9. Having an Advance Healthcare Directive helps healthcare professionals to care for you in the way you would like.
10.Having an Advance Healthcare Directive will save your loved ones having to decide what they think you would want.
11.If there is any doubt about an Advance Healthcare Directive, a person can go to the courts.