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National Healthcare Decisions Day April 16

Advance Care Planning: Your Decisions Matter

Presented By:[Name][Title][Organization]

[Date]


1. Discover the value of advance care planning

2. Learn how to talk about your future healthcare decisions

3. Understand how to document your healthcare decisions using advance directives

4. Encourage others to honor National Healthcare Decisions Day


Involves: Learning about treatment options

Thinking about your values

Talking about your decisions

Documenting your wishes


Advance Care Planning

&

Health Care DirectivesThanks to Hospice Minnesota for use of their content in this presentation.


1900 -- 47

Most people died quickly from accident or infection.

2000 -- 78

Most will die slowly from chronic disease.


If you are 50. . .81.8 (women)

77.9 (men)

If you are 65. . .84.2 (women)

81.3 (men)

U. S. Centers for Disease Control and Prevention


cancer pattern (20%)--long illness with decline just before death

dementia pattern (30%)--grow progressively more frail over time, up to 10 years

organ system failure (30-40%)--series of hospitalizations over several years leading up to sudden death

from Center to Improve Care for the Dying


63% die in hospitals. 17% die in long-term care facilities. Patients typically spend 8 days in ICU

comatose or on a ventilator before they die.

(Foley, 1995; Isaacs and Knickman, 1997)


A 1999 study showed that. . . 70% of people in the U.S. face tough medical

decisions at the end of life.

Baby-boomers were more willing to talk about sex and drugs with their teens than about end-of-life care with an aging parent.

National Hospice Foundation


Learning

Thinking

Talking

Putting it in writing


exercise your right to control your own care

guide others in making decisions for you

clarify your wishes in case of confusion or disagreement


Document which. . . states your preferences about health care

names someone to make decisions for you

applies ONLY when you cannot make decisions or communicate your wishes


a will or trust to distribute property and assets after death

a power of attorney for financial affairs


You WILL receive medical care. Your family may struggle with tough choices. You will have no choice about who makes decisions

for you. Decision-makers may disagree. You may not receive the kind of care you want.


Living Wills (1989)

Durable Power of Attorney for Health Care (1993)

Minnesota Health Care Directive (1998)


Naming an Agent – (Durable Power of Attorney for Health Care)

Health Care Instructions – (Living Will)

(may contain one or both)


be in writing be dated state the person’s name & bear the person’s

signature or mark be verified by a notary or two witnesses include either health care power of attorney or

health instructions or both be executed by person with capacity to do so


Talk to the person(s) before you make it official

Explain your beliefs, preferences and expectations

Make sure agent is willing to act on your behalf


at least 18 years old

willing to act on your behalf and carry out your wishes

not easily intimidated--a good advocate

able to make difficult, possibly life-or-death, decisions

physically near or available


Decide if agents will act

alone or together.


You are related to that person

or

You state why you want that person to serve as your health care agent


give permission for, refuse or withdraw a treatment, service or procedure

select health care providers

choose residence when related to health care

obtain copies of medical records

(Additional powers may be assigned.)


Make decisions even if I’m able

Carry out wishes about funeral, burial, etc.

Make mental health treatment decisions

Determine whether to continue pregnancy

Continue even if marital status changes


Health care goals Feelings about specific treatments Religious and spiritual beliefs Beliefs about quality and length of life Wishes for care when dying Preferences about organ donation


pain control

ventilator/respirator

nutrition support and hydration

cardiopulmonary resuscitation (CPR)

dialysis, medications (including antibiotics),

surgery, chemotherapy


DNR - Do Not Resuscitate (use CPR or mechanical means to restart breathing or heartbeat)

DNI - Do Not Intubate (insert tube and connect person to mechanical breathing device such as ventilator/respirator)


are different and separate from a health care directive

must be issued by a doctor

are recognized in Minnesota


The document must be

signed and dated

witnessed by a Notary Public or two individuals*

*Note limits on who can witness.


primary physician other health care providers health care agent(s) family members and close friends

Keep a list of who has copies!


Talk to your family and doctor(s) about your wishes.

Keep a current copy with you if you travel.

Keep your directive up to date.


Your health status changes

You move to another state

Your agent is no longer able to act on your behalf


Notify agent, family, doctor, and replace all old copies with new ones.

Destroy all old copies.

Your health care directive can bechanged or revoked as long as

you have capacity to do so.


Why should I complete a health care directive if I trust my family?

Can I be required to complete a health care directive?

What if I’ve already completed a Living Will or Durable Power of Attorney for Health Care?

Do I need an attorney to complete a health care directive?


Will my health care directive be valid if I am in another state?

Do I need a directive if I want all possible treatment?

How can I be sure that my directive will be honored?


You do not have to complete all of the questions or blanks on the form.

You may not have answers to some of the questions.

There are no right or wrong answers.

Starting the process is an important step.


Hospice Minnesota

(651) 659-0423

1-800-214-9597


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