Concept

Advance care planning is a process of structured discussion and

documentation woven into the regular process of care that is

reviewed and updated on a regular basis.

Advance Care

Planning

Current Care

Planning

Diagnosis Death

Capacity Loss

• PATIENTS PATIENTS BELIEVE IT’S THE BELIEVE IT’S THE DOCTORS JOBDOCTORS JOB

• INVOLVE PROXY INVOLVE PROXY EARLYEARLY

• ACKNOWLEDGE ACKNOWLEDGE EMOTIONAL EMOTIONAL STRESSSTRESS

• HELP TO HELP TO REFRAME REFRAME CONVERSATIONCONVERSATION

• ASK ABOUT PAST ASK ABOUT PAST EXPERIENCESEXPERIENCES

• DESCRIBE DESCRIBE POSSIBLE POSSIBLE SITUATIONSSITUATIONS

• WRITE A LETTERWRITE A LETTER

• THECONVERSATIONPROJECT.ORGTHECONVERSATIONPROJECT.ORG

• FIVE WISHES (ADULTS) FIVE WISHES (ADULTS) (AGINGWITHDIGNITY.ORG)(AGINGWITHDIGNITY.ORG)

• GO WISH CARDS (GOWISH.ORG)GO WISH CARDS (GOWISH.ORG)

• MAKING CHOICES (GUNDLUTH.ORG/ADVANCE-MAKING CHOICES (GUNDLUTH.ORG/ADVANCE-CARE)CARE)

• PREPAREFORYOURCARE.ORGPREPAREFORYOURCARE.ORG

• VOICING MY CHOICES (ADOLESCENTS) VOICING MY CHOICES (ADOLESCENTS) (AGINGWITHDIGNITY.ORG)(AGINGWITHDIGNITY.ORG)

• ENTER INTO THE ENTER INTO THE MEDICAL RECORDMEDICAL RECORD

• RECOMMEND RECOMMEND STATUTORY STATUTORY DOCUMENTSDOCUMENTS

• ENSURE ENSURE PORTABILITYPORTABILITY

• DETERMINE DETERMINE APPLICABILITYAPPLICABILITY

• CONSULT WITH THE CONSULT WITH THE PROXYPROXY

• READ & INTERPRET READ & INTERPRET THE ADVANCE THE ADVANCE DIRECTIVEDIRECTIVE

• FOLLOW UP FOLLOW UP PERIODICALLYPERIODICALLY

• NOTE MAJOR LIFE NOTE MAJOR LIFE EVENTSEVENTS

• DISCUSS, DISCUSS, DOCUMENT DOCUMENT CHANGESCHANGES

• ADVANCE PLANNINGADVANCE PLANNING• PERSONAL CHOICESPERSONAL CHOICES• CAREGIVERSCAREGIVERS• SETTINGSETTING

• LOSS, GRIEF, COPING LOSS, GRIEF, COPING STRATEGIESSTRATEGIES

• BE FAMILY FIRSTBE FAMILY FIRST

• EVERYONE EVERYONE COMFORTABLE IN COMFORTABLE IN THE ROLETHE ROLE

• SEEK PERMISSIONSEEK PERMISSION• CHANGE ROLES IF CHANGE ROLES IF

STRESSEDSTRESSED

• BURDENS & BURDENS & BENEFITSBENEFITS

• PERMIT FAMILY PERMIT FAMILY PRESENCEPRESENCE

• MINIMIZE FAMILY MINIMIZE FAMILY BURDENBURDEN

• BACK-UP SETTINGBACK-UP SETTING

• FINANCIAL & LEGALFINANCIAL & LEGAL

• FINAL GIFTSFINAL GIFTS

• AUTOPSYAUTOPSY

• BURIAL / BURIAL / CREMATIONCREMATION

• FUNERAL SERVICESFUNERAL SERVICES

• GUARDIANSHIPGUARDIANSHIP

• FAILURE TO PLANFAILURE TO PLAN

• PROXY ABSENT FOR PROXY ABSENT FOR DISCUSSIONSDISCUSSIONS

• UNCLEAR PATIENT UNCLEAR PATIENT PREFERENCESPREFERENCES

• FOCUS TOO NARROWFOCUS TOO NARROW

• MAKING MAKING ASSUMPTIONSASSUMPTIONS

Advance Care

Planning

Current Care

Planning

Diagnosis Death

Capacity Loss