advance care planning: more than a signature
DESCRIPTION
Adapted from the in progress Palliative Care International Curriculum. Takes an in-depth look at the longitudinal conversation required to plan for the end of life. Differentiates advance care planning from current care planning and describes the common pitfalls encountered during planning.TRANSCRIPT
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Concept
Advance care planning is a process of structured discussion and
documentation woven into the regular process of care that is
reviewed and updated on a regular basis.
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Advance Care
Planning
Current Care
Planning
Diagnosis Death
Capacity Loss
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• PATIENTS PATIENTS BELIEVE IT’S THE BELIEVE IT’S THE DOCTORS JOBDOCTORS JOB
• INVOLVE PROXY INVOLVE PROXY EARLYEARLY
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• ACKNOWLEDGE ACKNOWLEDGE EMOTIONAL EMOTIONAL STRESSSTRESS
• HELP TO HELP TO REFRAME REFRAME CONVERSATIONCONVERSATION
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• ASK ABOUT PAST ASK ABOUT PAST EXPERIENCESEXPERIENCES
• DESCRIBE DESCRIBE POSSIBLE POSSIBLE SITUATIONSSITUATIONS
• WRITE A LETTERWRITE A LETTER
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• THECONVERSATIONPROJECT.ORGTHECONVERSATIONPROJECT.ORG
• FIVE WISHES (ADULTS) FIVE WISHES (ADULTS) (AGINGWITHDIGNITY.ORG)(AGINGWITHDIGNITY.ORG)
• GO WISH CARDS (GOWISH.ORG)GO WISH CARDS (GOWISH.ORG)
• MAKING CHOICES (GUNDLUTH.ORG/ADVANCE-MAKING CHOICES (GUNDLUTH.ORG/ADVANCE-CARE)CARE)
• PREPAREFORYOURCARE.ORGPREPAREFORYOURCARE.ORG
• VOICING MY CHOICES (ADOLESCENTS) VOICING MY CHOICES (ADOLESCENTS) (AGINGWITHDIGNITY.ORG)(AGINGWITHDIGNITY.ORG)
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• ENTER INTO THE ENTER INTO THE MEDICAL RECORDMEDICAL RECORD
• RECOMMEND RECOMMEND STATUTORY STATUTORY DOCUMENTSDOCUMENTS
• ENSURE ENSURE PORTABILITYPORTABILITY
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• DETERMINE DETERMINE APPLICABILITYAPPLICABILITY
• CONSULT WITH THE CONSULT WITH THE PROXYPROXY
• READ & INTERPRET READ & INTERPRET THE ADVANCE THE ADVANCE DIRECTIVEDIRECTIVE
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• FOLLOW UP FOLLOW UP PERIODICALLYPERIODICALLY
• NOTE MAJOR LIFE NOTE MAJOR LIFE EVENTSEVENTS
• DISCUSS, DISCUSS, DOCUMENT DOCUMENT CHANGESCHANGES
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• ADVANCE PLANNINGADVANCE PLANNING• PERSONAL CHOICESPERSONAL CHOICES• CAREGIVERSCAREGIVERS• SETTINGSETTING
• LOSS, GRIEF, COPING LOSS, GRIEF, COPING STRATEGIESSTRATEGIES
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• BE FAMILY FIRSTBE FAMILY FIRST
• EVERYONE EVERYONE COMFORTABLE IN COMFORTABLE IN THE ROLETHE ROLE
• SEEK PERMISSIONSEEK PERMISSION• CHANGE ROLES IF CHANGE ROLES IF
STRESSEDSTRESSED
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• BURDENS & BURDENS & BENEFITSBENEFITS
• PERMIT FAMILY PERMIT FAMILY PRESENCEPRESENCE
• MINIMIZE FAMILY MINIMIZE FAMILY BURDENBURDEN
• BACK-UP SETTINGBACK-UP SETTING
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• FINANCIAL & LEGALFINANCIAL & LEGAL
• FINAL GIFTSFINAL GIFTS
• AUTOPSYAUTOPSY
• BURIAL / BURIAL / CREMATIONCREMATION
• FUNERAL SERVICESFUNERAL SERVICES
• GUARDIANSHIPGUARDIANSHIP
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• FAILURE TO PLANFAILURE TO PLAN
• PROXY ABSENT FOR PROXY ABSENT FOR DISCUSSIONSDISCUSSIONS
• UNCLEAR PATIENT UNCLEAR PATIENT PREFERENCESPREFERENCES
• FOCUS TOO NARROWFOCUS TOO NARROW
• MAKING MAKING ASSUMPTIONSASSUMPTIONS
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Advance Care
Planning
Current Care
Planning
Diagnosis Death
Capacity Loss
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