1. Sample Pix and Graphics To be used for presentations/posters Included here in no particular order Gathered from presentations of all six coalitions. Health Planning Council Betty Falcão, eaf6@cornell.edu

2. Who will make your health care the decisions? Health Care Agent Health Care Agent Family/friends Family/friends Strangers Strangers The Government The Government It’s up to each one of us!

3. Advance Care Planning: A Gift Clarify values, beliefs Clarify values, beliefs Choose an agent Choose an agent Understand life- sustaining treatments Understand life- sustaining treatments Practical issues Practical issues Compassion and Support at the End of Life

4. Clarifying Your Values and Beliefs Speak to your: Health Care Agent Family Family Spiritual Advisor Spiritual Advisor Physician Physician About Your: Values Spiritual Beliefs Personal Beliefs Hope and wishes What makes life worth living? What really matters to you?

5. Advance Care Planning Advance Care Planning Benefits Benefits Barriers Barriers

6. Misconceptions of CPR success may be a result of what we see on television. Popular television programs show an unrealistic CPR success rate of approximately 67%. CPR on Television Excellus BlueCross BlueShield

7. Advance Care Planning Why do it? Begins conversation Begins conversation Builds trust Builds trust Establishes relationship Establishes relationship Reduces uncertainty Reduces uncertainty Helps to avoid confusion and conflict Helps to avoid confusion and conflict

8. Practical Issues: Review and Update Periodically Periodically Major life events Major life events Newly diagnosed chronic illness Newly diagnosed chronic illness Advancing chronic illness Advancing chronic illness After complicated life- sustaining treatments After complicated life- sustaining treatments

9. The conversation is the heart of the advance care planning process.

10. You have choices How the Majority of Americans Die How the Majority of Americans Wish to Die Over 75% 80% Patricia Bomba, M.D. Vice President & Medical Director, Geriatrics

11. Advance Care Planning: Benefits Maintain Control Maintain Control Achieve Peace of Mind Achieve Peace of Mind Assure Wishes are honored when they are unable to communicate for themselves. Assure Wishes are honored when they are unable to communicate for themselves. For the senior, frail elder.

12. Invite Someone to Be Your Agent

13. Do you need to see a lawyer to complete a Health Care Proxy?

14. “Cancer” Trajectory, Diagnosis to Death Time Onset of incurable cancer -- Often a few years, but decline usually < 2 months Function Death High Low Cancer Possible hospice enrollment 15% of deaths Joanne Lynne, The Washington Home, Center for Palliative Care Studies

15. Organ System Failure Trajectory Function Death High Low (mostly heart and lung failure) Begin to use hospital often, self-care becomes difficult ~ 2-5 years, but death usually seems “sudden” Time 20% of deaths

16. Dementia/Frailty Trajectory Time Quite variable - up to 6-8 years Death High Low Onset could be deficits in ADL, speech, ambulation Function Over 50% of deaths