Advance Care Planning: It s About the Conversation
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- Coleen Greene
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1 Advance Care Planning: It s About the Conversation A program of the Wisconsin Women s Health Foundation Promoting the benefits of and improving processes for advance care planning across the state, in health care settings, and in the community.
2 Advance Care Planning (ACP): The process of understanding, reflecting on, and discussing future medical decisions, including end-of-life preferences. Why is ACP important? So the care you receive reflects your wishes. So health care professionals know your treatment preferences. So your family knows they are making the right decisions. 70% What people want: of people say they prefer to die at home. 70% What people do: die in a hospital, nursing home, or long-term care facility. 60% say it s extremely important to make sure their family is not burdened by tough decisions. 56% have not communicated their end-of-life wishes. 80% would want to talk with their doctor about end-of-life care if seriously ill. 7% report having an end-of-life conversation with their doctor. 82% say it s important to put their wishes in writing. 23% have actually done it.
3 Three Steps to Begin: STEP #1: Reflect on your values L o o k i n g b a c k Has anything happened in the past that shaped your feelings about medical treatment? What was positive about that experience? What do you wish would have been done differently? How do I feel about my personal, cultural, or religious beliefs? treatments that may prolong life? accepting death when it comes? comfort care (medical, spiritual, environmental)?
4 Three Steps to Begin: STEP #2: Choose a decision maker ( h e a l t h ca r e a g e nt) Photo from: National Hospice And Palliative Care Organization, Choose someone who: Can be trusted. Is willing to accept this responsibility. Is willing to follow your wishes, even if he or she does not always agree with them. Can manage conflict and make decisions in sometimes difficult situations. What do you expect from them? I trust you to work with my doctors. It s okay if you have to change my prior decisions if something is better for me at the time.... It s okay if you have to change my prior decisions, but there are some decisions that I never want you to change. These decisions are Follow my wishes exactly, no matter what.
5 Three Steps to Begin: STEP #3: Explore your goals for medical care I don t want to be a burden to my family. What does it mean for you to live well? I don t want to be in pain. I want to be mentally aware. I want to give and receive hugs. I want to be able to communicate with family.
6 An Advance Directive is a document with a person s: Creating an Advance Directive Goals, values and beliefs about health care treatment decisions, and who should make these decisions if the person is unable to make those decisions for him/herself. Make copies of your Advance Directive! Give one to your doctor. Give one to your health care agent. Keep one in a place where it can be easily found. Take one with you if you go to a hospital or nursing home and ask for it to be put in your medical record. Talk to the rest of your family and close friends. Tell them who your health care agent is and what your wishes are.
7 Review periodically Advance care planning is a process, not just a one-time event. Wishes may change as circumstances change. Review your wishes: Whenever you have a physical exam. Whenever one of the 5 Ds occur: Decade Diagnosis Divorce Decline in Health Death of a Loved One Your role as a Health Care Agent If you are a health care agent: Think about being prepared for this role as an act of caring. If you accept this role, commit to it. Trust yourself to do what is right. The person who chose you trusts that you can and will follow their wishes.
8 Conversation Starter Kit Be patient. Don t steer the conversation. Don t judge. A good or meaningful death means different things to different people. You and your loved ones can always change your minds as circumstances shift. Every attempt at the conversation is valuable. You don t have to cover everyone or everything right now. Resources: advance-care-planning
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