Planning Ahead for the Final Stages in Life

Presented by Julie Stanton, BCH

A two part legal document◦Healthcare Decisions- a person’s wishes for end of

life medical treatment.◦Durable Power of Attorney for Health Care-

designates a person (agent/proxy) to make health care decisions when a person is unable to.

◦Recommend for adults 18 years and older.

What is an Advance Directive?

Choose a person with “strength of character”.

Can not be a person hired to provide healthcare services for you.

Must be 18 years or older. (check your state’s requirements)

Recommended to choose a person who will not gain financially from your death.

Durable POA for Healthcare

“Against my beliefs-values.”

“I’m too young.”

Cultural beliefs or customs.

“Already have one.”

Barriers

Step 1: Introduce the conversation“This is important to me.”

Step 2: Explore personal beliefs and values

* Write done what is important to discuss Step 3: Discuss with medical provider &

family* Discussion with medical provider & family

Step 4: Document wishes*Fill out an Advance Directive or Five Wishes

document

How To Communicate

Timing is everything! * Not in a crisis

Private, comfortable place (Intimate conversation- have “reinforcements” )

Explain the importance of discussing your end-of-life wishes

Step 1: Introduce the Conversation

Quality of life or quantity? ◦ (treated with dignity)

What gives you strength? ◦ (Spirituality & Loved ones)

Discuss with Family & Friends◦ (reduce anxiety, guilt, grief, & bereavement)

Step 2: Explore Personal Beliefs & Values

Choices & Decisions

◦ Where do you want to spend your last daysNursing care facility, home care, assisted living

◦What kind of medical care do you want? Hospice

◦What will be your final arrangements?Funeral arrangements Trust and/or Will

Step 3: Define End-of-Life Wishes

Recommend a notarized signature ◦ Integrity of the document-(not required in New Mexico)

Always keep your Advance Directive up to date! (Review on your birthday)

You Can revoke or change any part(s) of your advance directive.

Give a copy to your Agent, Healthcare Providers, and family. (Never lock it away!)

About your Advance directive

Healthcare POA or Durable POA scope of decision making.◦Terminates at death

Organ donation vs. Body donation

Funerals are for the living◦“don’t want to be a burden or bother…”

Final Arrangements

Provides support and care for those in the last phases of life-limiting illness

Recognizes dying as part of the normal process of living

Affirms life and neither hastens nor postpones death

Focus on quality of life for individuals and their family caregivers

Comfort Care-Hospice Services

Patient’s Personal Provider Hospice Physician Nurses (CHPN) Licensed Social Workers Certified Nursing Assistants Spiritual Counselors/Chaplains Volunteers Other Integrated Healthcare Therapists

Hospice Care Team

Develops the plan of care◦ Family◦ Facility Staff◦ Care Giving Agencies

Manages pain and symptoms Attends to the emotional, psychosocial and

spiritual aspects of dying and care giving Teaches the family how to provide care Advocates for the patient and family Provides bereavement care and counseling

What does the Care Team do?

Medications – associated with their hospice diagnosis

DME and Supplies

Routine Care Respite Care Acute Care Inpatient Services

Supportive Services & Levels of Care

General◦Life-limiting illness, prognosis 6 months

or less if disease takes normal course

◦Live in service area

◦Consent to accept services◦Patient no longer seeking curative

treatment, only comfort care

Hospice Admission Criteria

Medicare (entitlement program) Medicaid Private Insurance VA Benefits Charity resources Self pay

How is hospice care paid for?

QUESTIONS & ANSWERS

Private Insurance, Medicare, & Medicaid

Mesilla Valley Hospice299 E. Montana, Las Cruces, NM 88005

575-523-4700 www.mvhospice.org Contact: Julie Stanton: jstanton@mvhospice.org

Caring Connections (NHPCO) ◦ 800-658-8898 www.caringinfo.org

Resources