1. Presented by Julie Stanton, BCH

2.  A two part legal document ◦ Healthcare Decisions- a person’s wishes for end of life medical treatment. ◦ Durable Power of Attorney for Health Care- designates a person (agent/proxy) to make health care decisions when a person is unable to. ◦ Recommend for adults 18 years and older.

3.  Choose a person with “strength of character”.  Can not be a person hired to provide healthcare services for you.  Must be 18 years or older. (check your state’s requirements)  Recommended to choose a person who will not gain financially from your death.

4.  “Against my beliefs-values.”  “I’m too young.”  Cultural beliefs or customs.  “Already have one.”

5.  Step 1: Introduce the conversation “This is important to me.”  Step 2: Explore personal beliefs and values * Write done what is important to discuss  Step 3: Discuss with medical provider & family * Discussion with medical provider & family  Step 4: Document wishes *Fill out an Advance Directive or Five Wishes document

6.  Timing is everything! * Not in a crisis  Private, comfortable place (Intimate conversation- have “reinforcements” )  Explain the importance of discussing your end-of-life wishes

7.  Quality of life or quantity? ◦ (treated with dignity)  What gives you strength? ◦ (Spirituality & Loved ones)  Discuss with Family & Friends ◦ (reduce anxiety, guilt, grief, & bereavement)

8.  Choices & Decisions ◦ Where do you want to spend your last days N ursing care facility, home care, assisted living ◦ What kind of medical care do you want? Hospice ◦ What will be your final arrangements ? Funeral arrangements Trust and/or Will

9.  Recommend a notarized signature ◦ Integrity of the document- (not required in New Mexico)  Always keep your Advance Directive up to date! (Review on your birthday)  You Can revoke or change any part(s) of your advance directive.  Give a copy to your Agent, Healthcare Providers, and family. (Never lock it away!)

10.  Healthcare POA or Durable POA scope of decision making. ◦ Terminates at death  Organ donation vs. Body donation  Funerals are for the living ◦ “don’t want to be a burden or bother…”

11.  Provides support and care for those in the last phases of life-limiting illness  Recognizes dying as part of the normal process of living  Affirms life and neither hastens nor postpones death  Focus on quality of life for individuals and their family caregivers

12.  Patient’s Personal Provider  Hospice Physician  Nurses (CHPN)  Licensed Social Workers  Certified Nursing Assistants  Spiritual Counselors/Chaplains  Volunteers  Other Integrated Healthcare Therapists

13.  Develops the plan of care ◦ Family ◦ Facility Staff ◦ Care Giving Agencies  Manages pain and symptoms  Attends to the emotional, psychosocial and spiritual aspects of dying and care giving  Teaches the family how to provide care  Advocates for the patient and family  Provides bereavement care and counseling

14.  Medications – associated with their hospice diagnosis  DME and Supplies  Routine Care  Respite Care  Acute Care Inpatient Services

15.  General ◦ Life-limiting illness, prognosis 6 months or less if disease takes normal course ◦ Live in service area ◦ Consent to accept services ◦ Patient no longer seeking curative treatment, only comfort care

16.  Medicare (entitlement program)  Medicaid  Private Insurance  VA Benefits  Charity resources  Self pay

17.  QUESTIONS & ANSWERS

18. Private Insurance, Medicare, & Medicaid Mesilla Valley Hospice 299 E. Montana, Las Cruces, NM 88005 575-523-4700 www.mvhospice.orgwww.mvhospice.org Contact: Julie Stanton: jstanton@mvhospice.orgjstanton@mvhospice.org Caring Connections (NHPCO) ◦ 800-658-8898www.caringinfo.org