Advance Care Planning:

It’s how we care for each other

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Advance Care Planning

How many people have heard about ‘advance care planning’?

It’s about having conversations! …About your values and wishes

…About who would speak for you if you couldn’t

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Why Should We Do

Advance Care Planning?

1. Canadians are living longer – but eventually, we all die.

2. Most Canadians die of chronic illnesses – and can live with these illnesses for many years before death.

3. Health care decisions can be complex – they may be easier to think about ahead of time.

4. ACP can ease the burden on loved ones to make decisions when you can’t.

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What We Know

• Advance care planning will:

– Reduce your family’s stress and anxiety.

– Improve your satisfaction with your care.

– Improve your quality of life and quality of death.

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Who Needs to do

Advance Care Planning?

Everyone.

You never know when you may face an

unexpected event or illness and will be unable to make your wishes known.

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Without a conversation…..

“I didn’t expect him to die so soon. My husband resisted

talking about dying and after 40 years of marriage. I feel he

let me down by not opening up and I guess I let him down for

not knowing how to talk about some of the things that I

needed to discuss. It would have been nice closure if things

had been different in the end. I can never get that time back.”

-CANHELP study participant

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Let’s get started…

The Speak Up campaign developed the “5 Steps” of advance care planning.

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How to Begin: The 5 Steps

1. Think about your values/wishes:

what is most important to you

2. Learn about medical information

relevant to your health concerns

(prognosis, benefits/risks, likely

outcomes, end-of-life care)

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How to Begin: The 5 Steps

3. Decide who will be your substitute

decision maker.

4. Talk – with your substitute

decision maker, your loved ones, and health care providers

5. Record your values and wishes.

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Step 1:

Think about Your Values & Beliefs

What makes my life meaningful?

Time with family & friends

My faith

Love for my garden, music,

art, work, hobbies, pet.

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Live independently?

Make my own decisions?

Enjoy a good meal?

Have my privacy upheld?

Recognize or talk with

others?

Step 1:

Think about Your Health

What do I value most, being able to…

How do I feel about being…

Kept alive with machines?

In a coma & not expected

to wake up?

Unable to recover from

permanent & severe brain

damage?

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Step 1:

Think About End of Life

Family and friends nearby

Religious rituals observed

Spiritual/religious leader

An open window

Listen to music I love

Hear people talk about my

life’s happy memories

If I were nearing death, what would I want to make the

end more peaceful for me?

If possible, would I prefer to die…

At home? In a hospice? In the hospital?

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Step 2:

Learn

Learn about information that relevant

to your current health situation.

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Step 2:Learn

If you’re diagnosed with an illness, ask your doctor

questions about what to expect in terms of…

• What your life will look like 6 months / 1 year / 5 years from now

• Odds of recovery picking one course of treatment over another

• Possible big changes in your health to prepare for

• Your ability to function independently

• If you decide against treatment

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Step 3:

Decide on Substitute Decision Maker(s)

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Step 3:

Substitute Decision Maker(s)

• Only if you are unable to make decisions yourself,

your healthcare providers will turn to your…

• Substitute Decision Maker(s):

– Make medical decisions on your behalf

– Gives or refuse consent to treatments

– Direct your care and advocate for your wishes,

if you have talked with them!

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Step 3:

Consent & Capacity

• As long as you have capacity health care providers must

ask you for consent or refusal of consent for health care

interventions/treatments

• Capacity to make healthcare decisions means that

– You must be able to understand relevant information.

– You must be able to grasp the likely outcome of a decision.

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Step 3:

How to decide on an SDM(s)

• Who do I trust to make decisions based on my values

and wishes?

• Who is able to communicate clearly?

• Who is willing and available to speak for me?

• Who can make difficult decisions in stressful situations?

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Step 3: Regional Differences

• Legal frameworks regarding substitute decision

makers vary between provinces and territories

• Check www.advancecareplanning.ca to find the

information for your province/territory

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Step 4:

Have the Talk!

Advance care planning means having discussions with your substitute decision maker(s), with family and friends, and your health care team.

Awkward? Maybe.

Important? Definitely!

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What do you need to do or think

about before you have the

conversation?

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Step 5:

Document Your Wishes

You can write your wishes down or

make an audio or video recording

Give copies to:

• Your substitute decision makers

• Your family

• Important friends

• Your healthcare providers

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Step 5:

Remember to Review and Revise

• Review and update your wishes…

– When there are life changes – births, deaths,

marriages, transitions, moves;

– When there is a change in your health status;

– When you change your mind about your preferences;

– When new information is available;

– Annually.

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Advance Care Planning in Canada

• Initiated by the Quality End-of-Life Care Coalition of

Canada & facilitated by the Canadian Hospice Palliative

Care Association

• Overseen by a national Task Group that is

interprofessional and represents many jurisdictions

• Research partnership with CARENET

2525

ACP Day

ACP Day is an annual awareness day to engage

organizations about ACP.

How to participate?

• Toolkit available at www.advancecareplanning.ca

• Contact info@advancecareplanning.ca

• Hashtag! #ACPDAY2017 and #mycommunity

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Resources

We have a variety of print & online resources!

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Resources

Check out the resources in your province/territory

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Resources:

Workbooks, Quick Guides, Videos, Wallet Cards

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Resources for First Nations Communities

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Resources for Prostate Cancer

Patients and Caregivers

Online/print workbooks

Conversation starters

Forums

Videos

Webinars

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Tools for Organizations

• Developed in partnership groups across the country

– To raise awareness

– To provide information

• A wide range of resources

– Posters

– Infographics, Videos

– All available electronically

and in print

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Tools for Professionals:

“Just Ask” Conversation Cards & Guides

• Questions to ask patients

– Have you talked to your SDM (or

anyone else) about your wishes?

– Do you have a living will, advance

directive, or advance care plan?

• Questions to ask yourself

– Did I ask my patient about preferences

for end-of-life care?

It’s about conversations.

It’s about wishes.It’s how we care for each other.

www.advancecareplanning.ca