April 16 was designated National Advance Care Planning, a day when we can all reflect on decisions concerning end-of-life care. The Clinical Ethics Committee invites you to learn more on advance planning by reading the following information capsules.
Take advantage of April 16 to talk about advance care planning with your clientele and your close ones, and take time to think about it for yourself!
Capsule 6: The family
If your family can make sound decisions, why the need of an advance care plan and to discuss it? In times of stress or distress, your family members might not think of what you really want and they might question some of the decisions you had previously made.
Don’t forget to tell your close ones about the person you chose as your Substitute Decision Maker. This person will speak in your name if you are no longer able to.
Capsule 5: Living will and Advance Care Plan
A living will is a good start, since it is considered a form of advanced plan. However, an important process of an advanced care plan is the discussion to be had with your close ones. They are the ones who will be making decisions in the event that you can no longer make them yourself. Therefore, it is important for your wishes to be clearly spoken.
Capsule 4 : When is an advance care plan used?
The advance care plan is only used when an individual is unable to make his or her own health care decisions (ex.: a coma or an advanced state of a degenerative disease which compromises one’s capacity to make decisions). The Substitute Decision Maker then uses the advance plan to guide the care for the patient and to express his or her wishes concerning treatments and end-of-life.
Capsule 3 : Significant research data about advance care planning
According to a poll conducted by Ipso-Reid in 2004, 70% of respondents (Canadians) had not prepared an advance care plan. Also, less than 44% of them had discussed end-of-life care with a close one.
Yet research show that patients who discuss an advance plan with their physicians and their close ones have better chances of being satisfied of the care they receive and place less of a strain on caregivers.
Capsule 2 : Choosing a Substitute Decision Maker
Preparing a plan enables you to choose a Substitute Decision Maker, a person who will talk in your name when you are no longer able to. He or she must know your wishes, choices, values and details of your advance care plan. It is the person who will consent to treatments that are proposed by health professionals or who will refuse them, in accordance with your plan.
It is important to choose a person who you trust. You will need to feel comfortable carrying out a conversation on your wishes and choices concerning end-of-life care with your Substitute Decision Maker.
Capsule 1 : What is advance care planning?
Advance care planning is a process of reflection and communication. It is a time to reflect on values and wishes concerning end-of-life in the event that we become unable to accept of refuse treatments or other medical interventions.
It is a plan that can contain information on treatments that you wish to receive or not (ex.: CPR, mechanical ventilation) as well as everything that concerns end-of-life (ex.: presence of family members, religious rituals, dying at home, etc.).
Reference: Canadian Hospice Palliative Care Association, Advance Care Planning, www.advancecareplanning.ca/home.aspx
Palliative Home Care
Teams of nurses and doctors, in collaboration with other services and community partners, pool all the knowledge regarding the patient’s physical and psychological state of health in order to maximize care to improve quality of life. They manage the assessment and stabilization of the patient’s state of health, ensure the care required, such as wound care and dressings, catheter or colostomy care, and manage pain symptoms.
What to do when a loved one dies?
When a loved one passes away, you may ask yourself "where do I go from here"? Consult our guide. You will find out more about resources, advice, phone numbers and other important information to help you.
Note that the guide is easier to read if you print it out and fold it as a booklet.