PLANNING FOR END OF LIFE CARE Heather Westaway Registered Kinesologist Manager, Health Sciences and Interprofessional Education Northern Ontario School of Medicine [email protected]Lori Rietze BScN, MSN, PhD (c) Registered Nurse Faculty, Laurentian University [email protected]learn strategies to support your conversations about end of life care 6-8pm R.H. MURRAY SCHOOL Whitefish, Ontario Sponsored by the Whitefish District Lions Club JOIN US MAY 20 2014 http://www.advancecareplanning.ca/health-care-professionals/videos.aspx
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PLANNING FOR END OF LIFE CARE Heather Westaway Registered Kinesologist Manager, Health Sciences and Interprofessional Education Northern Ontario School.
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PLANNING FOR END OF LIFE CARE
Heather WestawayRegistered Kinesologist Manager, Health Sciences and Interprofessional EducationNorthern Ontario School of [email protected]
“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…”
“Well then what is a Power of Attorney?”
How would the person making decisions for me know what
treatments I would have wanted?
Treatment Decision by the Substitute Decision Maker
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
Is the treatment likely to improve my condition or
well-being?
What are my expressed wishes
when I am capable?
Expressed Wishes = Advance Care Planning w SDM, when capable, in advance of hospitalization, at home
Treatment Decisions = Goals of Care w
doctor in hospital, in the moment
Advance care planning can
inform Goals of Care
Conversations
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
How will I make decisions about my care
at End-of-life?
So, What is Advance Care Planning then?
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 NOTAdvance Care Planning
then?• 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?
Page 16
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.
How will I start Goals of Care Conversations?
1. Make a list of any illnesses that you have (heart failure, dementia, cancer…)
2. Ask your doctor about your illness progression and trajectory
3. Ask your doctor about potential end of life treatments
4. Continue to ask questions about these treatments until you understand your options, risks and benefits
5. 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.caAdvocacy Centre for the Elderly: www.acelaw.ca