1. Being Mortal- Atul Gawande Presenters:
Wendy McCarty, Director-CHI Health at Home-Dickinson
Tami Christianson-Social Worker, Bereavement and Volunteer Coordinator,
CHI Health at Home-Dickinson
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2. Courage -Can it be physical, mental, emotional-just foolish?
-What is courage to you?
-Can it be physical, mental, emotional-just foolish?
-Plato’s definitions of courage:
*Endurance of the soul
*Wise endurance
*Knowledge of what is to be feared and what is to be hoped
*Courage is strength in the face of knowledge of what is to be feared or hoped
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3. Three modes of patient interaction by doctors:
According to Gawande-
1. The doctor knows best approach
2. The informative approach
3. The interpretive approach
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4. Tough Questions
-When should we try to fix, and when should we not? -Why do you think it is so difficult for Doctors and/or families to refuse or curtail treatment? -Do you think that advancements in the medical field damage our ability to have a quality end of life? -How do you walk the fine line between being hopeful and being unrealistic? -What do we really expect of medicine?
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5. Being Mortal- Atul Gawande
Video-
Being Mortal-
Atul Gawande
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6. Discussion Points
-Should medical schools expand the curriculum to include end-of-life issues? -What is your attitude, toward old age? -Should doctors intervene if they think the patient made a bad choice? -How do you think your family would react if you told them, “I’m ready”? -What do you fear most about the end of life?
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7. Planning Ahead: Advance Directives and End-of-Life Decisions
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8. Our Goals Discuss advance directives and end-of-life care decisions
Learn the different types of advance directives
Recognize advantages and disadvantages of advance directives
Identify resources that can help you complete your advance directives.
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9. Do you have a Map?
….a written plan stating what health care treatments you would or would not want if you could not speak for yourself?
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10. Why YOU Need an Advance Directive
Your wishes will be known
Only used if you are unable to express your decisions
This can happen to anyone-at any age
Give your loved ones the gift of peace of mind-write down your wishes!
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11. Interesting to note…
Most Americans-88 percent- feel comfortable discussing issues relating to death and dying
Yet research has found that only 42% have a living will.
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12. What are Advance Directives?
A written statement of your wishes, preferences and choices regarding end-of-life health care decisions.
A tool to help you think through and communicate your choices
It is a road map for your future health care.
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13. Advance Directives
Written instructions about future medical care are only used:
If you are seriously ill or injured AND
Unable to speak for yourself
Two parts to an advance directive:
Living will
Medical (health care) power of attorney
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14. Living Will A living will is one part of an advance directive
A legal document with your wishes about medical treatment
You choose what you do want & don’t want
Think of it as a route on your map
It’s YOUR journey
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15. Medical Power of Attorney
A document that specifies who you want to make decisions about your medical care
The person is authorized to speak for you ONLY if you are unable to make your own medical decisions
May also be called:
-Health care proxy or agent
-Health care surrogate
-durable power of attorney for health care
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16. Advance Directive Advantages
You are in charge of making your own decisions
Documents can be changed anytime
You DO NOT need an attorney
Documents can help you express your wishes
Forms are available for FREE at
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17. Advance Directive: Disadvantages
Advance Directives (AD) may not be available when needed
Not readily available in patient charts
Living wills:
-may not be specific enough
-may be overridden by a treating physician
-does not immediately translate into physician’s orders
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18. Medical Terms: End-of-Life Care Decision Making
Life-Sustaining Treatment
Artificial Nutrition and Hydration (tube feeding)
Cardiopulmonary Resuscitation (CPR)
Do-Not-Resuscitate Order (DNR)
Palliative Care
Hospice
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19. Other Directives
POLST
MOLST
Five Wishes
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20. Free Resources from CaringInfo.org
State-specific advance directive forms
Information on “Planning ahead” and talking with loved ones and care providers
Brochures to download:
-Understanding Advanced Directives
-You have filled out your Advance Directive-Now what?
-End-of-Life Decisions
-Conversations before the crisis
-Ask Tough Questions
-Communicating end-of-life wishes
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21. Additional Information Available to you at:
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