Caring House The Smarties Series Advance Care Planning 1. Twelve - - PDF document

▶

Apr 08, 2024 223 likes •322 views

Caring House The Smarties Series Advance Care Planning 1. Twelve Reasons Advance Directives Fail and How to Avoid Them. (Sep 12) for Smarties 2. Who Ya Gonna Name? Plus Advance Directives October 3, 2017 101. (Sep 19) 3. What Ya Gonna Tell Em?

SLIDE 1

Page 1

Providing peace, comfort and support to men and women at the ends of their lives

Caring House

Advance Care Planning for Smarties October 3, 2017 I’ve Been Named: How Do I Do an Amazing Job?

The Smarties Series

1. Twelve Reasons Advance Directives Fail and

How to Avoid Them. (Sep 12)

2. Who Ya Gonna Name? Plus Advance Directives
101. (Sep 19)
3. What Ya Gonna Tell Em? (Sep 26)
4. I’ve Been Named. How Do I Do an

Amazing Job? (Oct 3)

5. Care Lingo Decoded. Plus California’s End of

Life Option Act. (Oct 10)

Background

Ellen Gorbunoff, RN Ed Long, JD Handouts Time Questions

Handouts, Slides and More

You can get all class materials and be notified about future classes by signing up at

YourCaringHouse.org/materials

Aging Preparedness

1. Power of Attorney for Health Care*
2. Think and Communicate With

Helpers*

3. Power of Attorney for Financial Matters
4. Your Estate Plan
5. Your Plan for Long-Term Care
6. Your Plan for Funeral and Burial

Based on H.E.L.P .’s Your Aging Preparedness Kit Nuts & Bolts Guide

Advance Care Planning*

1. Power of Attorney for Health Care*
2. Think and Communicate With

Helpers* Advance care planning is for all adults – not just those who are older than I am.

SLIDE 2

Page 2

Core Concepts

1. You have a right to decide whether to
- start,
- decline or
- stop

available medical treatment (“care decisions”).

2. You have a right to name another person

to make care decisions for you.

Keep Score / Up to Date

Agent selection Documentation What’s Important Communication

Copies at yourcaringhouse.org/scorecard

Legal Lingo

Principal

The person signing the advance directive naming others to make decisions for them.

Agent

A person named to make decisions under an advance directive.

Star Trek Prime Directive

SLIDE 3

Page 3

Starfleet personnel shall not interfere with the internal development of alien civilizations.

Agent’s Prime Directive

1. Follow the Principal’s wishes
2. If not known, follow the Principal’s values

and views

3. If not known, use Agent’s best judgment

and act in the Principal’s best interests

Agent’s Top Duties

1. Speak for and make care decisions for

the Principal

2. Communicate with the Principal to learn

wishes, values and views

3. Keep up to date

Principal’s Top Duties

1. Communicate wishes, values and view to

the Agent

2. Strengthen and support the Agent
3. Keep up to date

Agent’s Part of the Conversation

Listen Ask questions Echo back in your own words Confirm that you both understand

Principal’s wishes, values and views

Communicate

Two monologues do not equal a dialogue

SLIDE 4

Page 4

Let’s Vote

Would you be comfortable saying “I don’t understand” to a doctor?

1. Yes
2. No

Agent’s List of Tasks

See your handout Let’s create a list of tasks

Task #01

Regularly communicate with the Principal and others.

Task #02

Get educated about how to do an awesome job.

Task #03

Be available when needed.

SLIDE 5

Page 5

Task #04

Let the healthcare team know that you are the Agent.

Task #05

Establish who will be the “MD Quarterback.”

Task #06

Ask questions until you have enough information.

Task #07

Understand the context.

Context

Just getting started vs. ODTAA Syndrome Progressive illness? What stage? Exhaustion? Looking for a cure vs. Peace Time

Task #08

Set and revise Goals of Care.

SLIDE 6

Page 6

Goals of Care

Return to Good Health Create a Good Death See Your Way page 11 Combat or Slow Illness Peace and comfort

Task #09

Make decisions.

Two Hands Up?

 Question #1 --

Would the treatment be medically helpful?

 Question #2 --

Would the Principal say “Yes” to the treatment?

Two Hands Up?

Pursue the treatment if Don’t pursue the treatment if

Task #10

Set time limits

Hours, days, weeks

Task #11

Keep family informed.

SLIDE 7

Page 7

Task #12

Self-care.

About Caring House

The first and only non-medical home in

Los Angeles County totally focused on end-of-life care

An IRC 501(c)(3) nonprofit Volunteer originated, professionally

staffed, volunteer supported

Revenues from resident/family payments

and community donations

John’s Story Where to Find Help

Doctor Nurse Social worker Spiritual care Bioethics committee Family and friends

Additional Resources

 Your Way, A Guide to Help You Stay in

Charge of Decisions About Your Medical Care, from H.E.L.P .

 Hard Choices for Loving People, by Hank

Dunn.

 End-of-Life, Helping with Comfort and Care,

from NIA & NIH

 Being Mortal, Atul Gawande, book and

Frontline documentary

SLIDE 8

Page 8

Kanako is the Principal You are the Agent

Woman, age 76 Dementia, not recognize family for 2 years In hospital for urinary tract infection Can no longer swallow Feeding tube is proposed

Agent’s Prime Directive

1. Follow the Principal’s wishes
2. If not known, follow the Principal’s values

and views

3. If not known, use Agent’s best judgment

and act in the Principal’s best interests

Deciding on Feeding Tube

What wishes, values and views of Kanako

would tell you

Yes on feeding tube? No on feeding tube? Time limits on feeding tube?

SLIDE 9

Page 9

Five Guiding Principles

1. Know Principal’s wishes, values and views
2. Gather information
3. Set goals of care
4. Decide on care/treatment with time

limits

5. Re-evaluate and return to #1