Kathryn Cunning, Practice Nurse General Practice plays a key role in - - PowerPoint PPT Presentation

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Kathryn Cunning, Practice Nurse General Practice plays a key role in - - PowerPoint PPT Presentation

Dr Helen Tom, General Practitioner & Kathryn Cunning, Practice Nurse General Practice plays a key role in Witnessing of Power of Attorney Forms Encouraging discussion re: End of Life Wishes Witnessing of Advanced Care Directives


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Dr Helen Tom, General Practitioner & Kathryn Cunning, Practice Nurse

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General Practice plays a key role in

 Witnessing of Power of Attorney Forms  Encouraging discussion re: End of Life Wishes  Witnessing of Advanced Care Directives

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Brought to our attention early 2009: 84yr old woman, living with her Son & DIL, in Bendigo

 Multiple health issues including:

  • Diabetes Mellitus Type 2
  • Vascular Dementia
  • Chronic Renal Failure
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 Developed Osteomyelitis with Rt 2nd Toe

amputation

  • Prolonged hospital admission due to issues of

guardianship

  • Deemed not competent to make her own decisions
  • VCAT hearing appointed her Grandson, who lived in

Melbourne, her Guardian

  • He transferred her to the Austin Hospital for more

Acute Care

  • Recognised the need for all patients to have Medical

Power of Attorney & Advanced Care Planning.

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 A Clinic decision was made to include the

discussion of Medical Power of Attorney & Advanced Care Planning, at all Health Assessments & Care Plans where relevant.

 Target Population : Over 75yr old patients in

their Health Assessments MY ROLE:

  • Discussion with the patient
  • Witness of relevant documents
  • Provision of Advanced Care Document
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  • Medical Power of Attorney
  • Less than10% of Over 75yr old patients had

completed Medical Power of Attorney

  • Advanced Care Directive
  • Less than 5% of Over 75yr old patients had

completed an Advanced Care Directive

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 Seeking Legal Advice initially from OPA  Over 75 Year Health Assessment  Comprehensive Medical Assessments (CMA’s)  GP Management Plans (GPMP & TCA)  General Public  TEMPLATES DEVELOPED:  Over 75yr Health Assessment  Advanced Care Directive

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  • Medical Power of Attorney
  • Over 95% of the Over 75yr old patients now have

a completed Medical Power of Attorney

  • Advanced Care Directive
  • Less than 50% of the Over 75yr old patients have

completed an Advanced Care Directive.

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 93 yo Woman

  • Mild dementia
  • Heart Failure
  • Peripheral Neuropathy
  • She is medically managed and has told her MPO

that she does not want to be kept alive if fully demented.

  • Can Medical POA ask her doctor to cease her heart

medications when she can no longer make decisions for herself?

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SLIDE 11

 78 yo woman life long intellectual disability

living in an aged care facility

  • Facility policy is that everyone must have an ACD. In

absence, the staff are advised in medical emergency to fully resuscitate

  • The staff and doctor felt that full resuscitation

would be a burdensome intervention.

  • Her brother in Maryborough,

who never visits, asked for full resuscitation in a medical emergency . He does not have MPOA.

  • Do we need to contact her guardian to override his

wishes

  • r

can the doctor and nurses make a decision?