1. Advance Care Planning VAN Forum October 12, 2010 Michele Fedderly Minnesota Network of Hospice & Palliative Care

2. Advance Care Planning – Giving A Gift Holiday Season Holiday Season Over 18? Over 18? To yourself and to others To yourself and to others Start Early Start Early Peace of Mind Peace of Mind

3. Advance Care Planning Making your wishes known Making your wishes known Discuss choices with family, loved ones, and providers Discuss choices with family, loved ones, and providers Reflect upon these choices in light of personal values, goals, and religious or cultural beliefs Reflect upon these choices in light of personal values, goals, and religious or cultural beliefs Choose a Health Care Agent Choose a Health Care Agent Complete a Health Care Directive and POLST form Complete a Health Care Directive and POLST form

4. Advance Care Planning Conversations That Matter Conversations That Matter Health Care Directives Health Care Directives POLST POLST

5. Advance Care Planning Why do it? Why do it? Most of us will die under the care of a health professional Most of us will die under the care of a health professional Up to 50% of people are unable to make their own health care decisions when they are near death Up to 50% of people are unable to make their own health care decisions when they are near death Health professionals typically treat when they are uncertain Health professionals typically treat when they are uncertain Loved ones has a significant chance of not knowing a person’s views without discussion Loved ones has a significant chance of not knowing a person’s views without discussion

6. Advance Care Planning What may it include ? What may it include ? Who makes decisions … health care agent Who makes decisions … health care agent Their authority Their authority How decisions should be made How decisions should be made When medical treatment should be continued or forgone When medical treatment should be continued or forgone What it means to live well What it means to live well

7. Advance Care Planning – Conversations That Matter How to get started? How to get started? Remember it is a gift! Remember it is a gift! Conversation could be with a parent, spouse or friend Conversation could be with a parent, spouse or friend Easier to have the conversation when death is not yet an issue Easier to have the conversation when death is not yet an issue Talk about what you have done to prepare Talk about what you have done to prepare Discuss situation of a friend who may be ill Discuss situation of a friend who may be ill Mention an article you have read Mention an article you have read

8. Advance Care Planning – Conversations That Matter Or if that does not work… Or if that does not work… Ask a friend or relative to talk with them Ask a friend or relative to talk with them Their doctor Their doctor Their lawyer Their lawyer Their faith person Their faith person

9. Advance Care Planning – Conversations That Matter When you have a conversation … When you have a conversation … Uninterrupted or Distracted Uninterrupted or Distracted Listen, Listen Listen, Listen Can be awkward Can be awkward Conversation s Conversation s Practical Details Practical Details

10. Health Care Directive Written document Written document Purpose of a Health Care Directive Purpose of a Health Care Directive Allows you to appoint a Health Care Agent Allows you to appoint a Health Care Agent Provides a place for your written instructions Provides a place for your written instructions Gives you an opportunity to give additional information for your designated health care agent Gives you an opportunity to give additional information for your designated health care agent Requires that you and two witnesses sign Requires that you and two witnesses sign

11. Health Care Directive Should be reviewed when you… Should be reviewed when you… Start a new decade of your life Start a new decade of your life Experience the death of a loved one Experience the death of a loved one Get married, divorced, or have a major family change Get married, divorced, or have a major family change Receive a diagnosis of a serious health condition Receive a diagnosis of a serious health condition Find your health condition is declining Find your health condition is declining

12. Health Care Directive Honoring Choices Minnesota Honoring Choices Minnesota Community-wide effort Community-wide effort All metro health care systems will be using the same form [different logos] and can transfer easily between health systems All metro health care systems will be using the same form [different logos] and can transfer easily between health systems Trained facilitators to assist in completing the Health Care Directive Trained facilitators to assist in completing the Health Care Directive

13. POLST Provider Orders for Life Sustaining Treatment Provider Orders for Life Sustaining Treatment Turns your Health Care Directive into Provider Orders Turns your Health Care Directive into Provider Orders Provider = MD, DO, and NP/PA [when delegated] Provider = MD, DO, and NP/PA [when delegated] When first-responders arrive can honor the orders When first-responders arrive can honor the orders Being used in the metro area and in other self- selected communities … will be expanded Being used in the metro area and in other self- selected communities … will be expanded

14. Questions Questions Contact information: Contact information: Minnesota Network of Hospice & Palliative Care Minnesota Network of Hospice & Palliative Care www.mnhpc.org 651-659-0423 www.mnhpc.org 651-659-0423www.mnhpc.org