Overview of Advance Care Planning Process
Explore the importance of Advance Care Planning (ACP) in healthcare, stressing the need for discussing future medical care goals with loved ones. Learn about clarifying goals, appointing decision makers, and completing advance directives. Understand the significance of naming a health care proxy and engaging in conversations about values and preferences for quality end-of-life care.
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Presentation Transcript
Advance Care Planning Rotary Meeting 12/16/20 Ken Brummel-Smith, MD Chairs, Ethics Committee, Mercy Medical Center Former Chair, Department of Geriatrics FSU College of Medicine
Reasons to Plan Ahead The future is known Things happen in medical care that people may not want You can control the future These decisions are something everybody should talk more about
Advance Care Planning (ACP) A process over time Involves discussing goals, desires and wishes for future medical care with loved ones Especially important when you can t make your own decisions Should be a routine part of medical care It is NOT just signing forms
Advance Care Planning (ACP) Clarify goals and wishes Name a decision maker or agent Identify care you want and don t want Completes an advance directive form Dr. completes a POLST form when appropriate Ultimate goal: support your self-determination
Step 6 Talking About Goals What Matters? What is most important in your life now? What experiences have you had with serious illness? Which fits your values? Treat intensively - even if it means suffering - to try to extend life Use medical treatments but stop if you are suffering too much, even if it means a shorter life Use all measures to promote comfort, even if it means a shorter life Can you imagine a health situation that would be worse than death? Have you changed your mind about what is important over time?
Advance Directives Naming a health care agent Completing an Advance Health Care Directive California form Five Wishes Online resources Prepare for Your Care
Health Care Proxy or Agent Name someone you can trust Someone who can live without you Someone available Most important discuss with them what you want!
Whos the Agent? Spouse/domestic partner Adult child Either parent Adult sibling Grandparent Adult aunt/uncle Adult niece or nephew A surrogate is someone who makes decisions if there is no written advance directive
Physician Orders - POLST Physician Orders for Life-Sustaining Treatment POLST form the Pink Form Only for people who have less than 1 year to live or are very frail (nursing home residents) Shown to ensure care more than the DNR order does www.polst.org
Advanced Advance Care Planning 80% Survey: 75 year-old patients and their physicians 60% 76% 67% 40% 20% 17% 10% 0% Patient thought about what they want Patient talked to doctor about their wishes Doctors thought about treatment for those patients Doctors talked to patient about it 11 Kohn M. Menon G. Life prolongation: views of elderly outpatients and health care professionals. JAGS;36(9):840-4, 1988
What Next? Get the forms and look them over Get The Conversation Stater Kit Have the conversation with your family Talk it over with your doctor Complete an advance directive Give copies to your family, doctor, clergy, hospital https://theconversationproject.org/starter-kits/
