DOCSLIB.ORG

My Advance Care Planning Guide

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
My Advance Care Planning Guide MY ADVANCE CARE PLANNING GUIDE For North Carolina TALK! et’s and L r values l us you hcare. Tel ur healt bout yo beliefs a on onversati ave the c . time to h ur family Take n and yo r physicia with you honest. open and Always be our t about y no doub Leave nces. d prefere values an Keep your documents up do date and available. We want to know To complete an Advance Care Plan: your wishes Go to www.sentara.com/advancedirectives Call Sentara Albemarle Medical Center (252) 384-4125 or the Sentara Center for so we can Healthcare Ethics at (757) 252-9550 or honor them. 1-800-Sentara (736-8272) Ask your physician or healthcare provider Table of Contents Have the TALK – Protect your rights to control healthcare decisions ..................1 Important Conversations .......................................................2 Terms You May Need to Know ..............................................3 What Powers am I Giving to my Healthcare Agent? ...............6 Questions and Answers .........................................................7 Have the TALK! Protect Your Right to Control Your Healthcare Decisions Healthcare is vitally important to everyone. Wherever you are, whatever the situation, you want to be sure you receive excellent medical treatment. But even more importantly, you want your medical choices to be understood and honored. The law guarantees your right to If you plan now, in advance, you can make make those decision about your medical sure your wishes are known, and that you care, even when you are too sick or get the kind of care you want and relieve injured to make your wishes known. your family of having to make difficult These “rights” give you control over your and stressful choices. You decide, in choices at a critical advance, in writing, time in your life. You what your healthcare can choose to accept choices are if you cannot speak for or refuse any medical “Having Mom’s Advance yourself, and you can treatment that is offered Care Plan made things so specifically direct the by your physicians. Your kind of medical treat- physicians will assist much easier at a difficult time. ment you do or do not you by informing you of Now I am doing the same for want if, e.g. you become the risks of the medical terminally ill, or have a permanent and severe interventions, the my own family.” brain injury with no hope benefits you might of improvement or expect and possible recovery. You can let alternatives. But, how your family, friends, can you be sure that your choices will be doctors, and healthcare providers know honored if you are unable to speak for your treatment wishes through your yourself? Advance Care Plan. 1 Important Conversations about Your Healthcare Choices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³YDOXHVKLVWRU\´DQGKDYHDFOHDU XQGHUVWDQGLQJ RI \RXU KHDOWK )RU H[DPSOH \RX FRXOG GLVFXVV \RXU YDOXHV DQG ZLVKHV ZLWK ORYHGRQHVRUDGYLVRUVRUZULWHGRZQ\RXUUHVSRQVHVWRTXHVWLRQVVXFKDV s :KDW GR , NQRZ DQG IHHO DERXW P\ s +RZGRP\SHUVRQDOUHODWLRQVKLSVDIIHFW KHDOWKVLWXDWLRQWRGD\" PHGLFDOGHFLVLRQPDNLQJ" s :KDW FRPSOLFDWLRQV PLJKW , s :KDW UROH GR , ZLVK P\ SK\VLFLDQV DQG H[SHULHQFH IURP P\ FXUUHQW KHDOWK RWKHUV WR SOD\ LQ PHGLFDO GHFLVLRQ FRQGLWLRQ" PDNLQJ" s ,VLWLPSRUWDQWIRUPHWREHLQGHSHQ s :KDW NLQG RI OLYLQJ HQYLURQPHQW LV GHQWDQGVHOIVXIILFLHQWLQP\OLIH" LPSRUWDQWWRPH" s :KDWDUHP\WKRXJKWVDERXWLOOQHVV s :KDWUROHGRUHOLJLRXVVSLULWXDOHWKQLFRU GLVDELOLW\G\LQJDQGGHDWK" FXOWXUDOEHOLHIVSOD\LQP\OLIH" s +RZGR,IHHODERXWGRQDWLQJP\RU s :KDW DUH P\ WKRXJKWV DERXW OLIH LQ JDQV" JHQHUDO WKDW LV P\ KRSHV DQG IHDUV HQMR\PHQWVDQGVRUURZV" t +RZGR,IHHODERXWJLYLQJP\ERG\ DVDQDQDWRPLFDOJLIWIRUUHVHDUFK" $GYDQFH&DUH3ODQs (North Carolina - Advance Directive for a "Natural Death" and Health Care Power of Attorney) are available from any staff member orthey can also be downloaded at 2 www.sentara.com/advancedirectives ~ 6(17$5$ Terms You May Need to Know The following terms are referred to in this booklet. We hope this list will help you understand some of the terms and what they may mean for you as you make healthcare choices for your future. Advance Care Planning: Facility A process of decision-making done in advance of Do Not Resuscitate Order (DNR): an illness or injury to plan with your family, In a hospital or other healthcare facility, DNR is a physicians, or spiritual leader what choices you physician’s order to withhold CPR from you in the would make if you became unable to communicate event of cardiac or respiratory arrest. An those choices for yourself. Sometimes the TALK Advance Care Plan does not automatically is done with a trained Advance Care Planning become a DNR order. This must be discussed Facilitator. with, and implemented by your physician. Advance Care Plan: Portable An Advance Care Plan is a term that includes Do Not Resuscitate Order (DNR): A written Advance Directive for a Natural Death as well as physician’s order to withhold CPR in the event of a Health Care Power of Attorney. While the cardiac or respiratory arrest that can travel with the content may be the same or similar, the main patient. This document must be on the State difference is an Advance Care Plan puts more approved DNR form, or MOST form (Medical Order emphasis on TALKing with family, physicians and for Scope of Treatment), to be honored by spiritual advisors about your wishes. Emergency Medical Services. Cardiopulmonary Resuscitation (CPR): Healthcare Agent: CPR involves chest compressions, medications, An adult appointed by you to make healthcare electric shock, and a breathing tube connected to decisions for you. This person speaks for you only a mechanical ventilator. The risks and benefits of when you can no longer speak for yourself. If you this treatment should be discussed with your have made your wishes known through a Advance physician with any change in your health or when Care Plan or have personally discussed your wishes you have a serious or life-limiting illness. with your healthcare agent, he or she is bound by Declarant/Principal law to make decisions in accordance with your A declarant is another word for the individual wishes. If they do not know your wishes, they will signing the Advance Directive for a Natural Death. make decisions they believe are in your best A principal is another word for the individual interest and that you would have made for yourself. appointing healthcare agent(s) pursuant to a Healthcare Power of Attorney. Because the This agent may also be identified as a Medical declarant and principal are the same person, often Power of Attorney or Healthcare Proxy depending these terms are used interchangeably. on the source of the document. 3 Life-Prolonging Procedure: MOST (Medical Order for Scope of Treatment): Any medical procedure, treatment or A written physician’s order which includes orders to intervention which: (i) uses mechanical or provide or to withhold CPR in the event of cardiac or other artificial means to support and prolong respiratory arrest, but also may include orders for other treatment options. Like the DNR, your life if you have no reasonable Portable this form travels with the patient. expectation of recovery from a terminal condition; and (ii) when applied to you in a Surrogate Decision-Maker: Individual(s) terminal condition, would serve only to designated by law to make healthcare decisions prolong the dying process. The term on your behalf, when you are unable to make includes artificially administered hydration decisions for yourself, if you have not named a and nutrition. Life-prolonging procedures do Healthcare Agent or Medical Power of Attorney. not include giving you medication or In order of priority, pursuant to N.C. Code performing any medical procedure §90-322 those persons are: necessary to provide you with comfort care 1. or to alleviate your pain. A guardian of the patient's person, or a general guardian with powers over the Living Will: patient's person, appointed by a court, provided that, if the patient has a health Often thought of as medical instructions care agent appointed pursuant to a valid only for end of life, a Living Will can actually health care power of attorney, the health capture health care preferences or your care agent shall have the right to exercise beliefs and values for any healthcare crisis. the authority to the extent granted in the health care power of attorney. This 'plan' is now incorporated in Advance Care Plans and is part of the larger process. 2. A health care agent appointed pursuant to a The terms Living Will, Advance Directive valid health care power of attorney and Advance Care Plan are often used in 3. Attorney-in-Fact appointed by patient. the same way. 4. The patient’s legal spouse. Organ and Tissue Donation: Donation 5. Majority of reasonably available parents and of your organs (such as heart, lungs, liver or adult children of the patient. kidneys) or other parts of the body (such as eyes, skin and bone) after death. 6. Majority of reasonably available adult brothers/sisters of the patient. 7. Persistent Vegetative State: An individual who has an established An incurable and irreversible condition, relationship with the patient, who is acting in caused by injury, disease or illness, that good faith on behalf of the patient, and who causes a loss of consciousness with no can reliably convey the patient's wishes. behavioral evidence of self-awareness or awareness of your surroundings and from Terminal Condition: which, to a reasonable degree of medical An advanced, irreversible condition caused by injury or probability, there can be no recovery.
Load more

Recommended publications
  • Advance Care Planning
    ADVANCE CARE PLANNING Position Statement Palliative Care Australia is the national peak body established by the collective membership of eight state and territory palliative care organisations and the Australian and New Zealand Society of Palliative Medicine. Together the Palliative Care Australia members network to foster, influence and promote local and national endeavours to realise the vision of quality care at the end of life for all.1 Palliative Care Australia believes • Dying is part of life. • Quality end of life care is realised when it meets the person’s needs and upholds their care preferences. • Advance care planning provides a mechanism to improve the quality of end of life care for people. It enables the coordination of their desired access to resources and services, to match their anticipated care needs. • Advance care planning offers everyone, and especially people living with a terminal condition, their families and significant others the opportunity to take control of decisions which affect their care. • Advance care planning should not be considered only relevant to people nearing the end of life but be considered by everyone. It should be considered as an ongoing conversation between the individual, their care team and as appropriate their family, significant others and carers. • All Australians should be supported to consider and provided the opportunity to specify the type of care they would like to receive at the end of life. Continual reassessment of current circumstances and likely future scenarios are part of this consideration. • Advance care planning should be applied and promoted across the health sector. Facilitating end of life discussions and supporting and engaging in advance care planning is the responsibility of the whole health care system, and should engage all members of the care team.
    [Show full text]
  • Legal & Ethical Considerations for Advance Care Planning And
    The Nurse's Role in Palliative and End‐of‐Life Care Across the Lifespan Plenary III: Legal & Ethical Considerations for ACP & PEOLC Patient Self-Determination Act of 19901 Mandates that patients must be queried Legal & Ethical Considerations about the existence of advance directives and that such advance for Advance Care Planning directives be made available to them if and Palliative End of Life Care they wish To make Patient Self-Determination Act LINDA GOBIS, JD, MN, RN reality, health care providers must CLINICAL ASSISTANT PROFESSOR themselves understand the act and its UNIVERSITY OF WISCONSIN OSHKOSH COLLEGE purposes and should be able to answer OF NURSING patients' questions. Advance Directives Are Challenging Individuals Who Should Consider Advance Directives The most challenging aspect of preparing an advance directive is assisting patients Patients who have no legally designated in identifying their preferences for surrogate or who could be denied the treatment. right—e.g., same sex partners WI Nursing Coalition Summit was held in Patients with unusual or highly specific 2012 to discuss the nurse’s role in preferences advance care planning and develop an Patients and families for whom the action plan for Wisconsin. existence of a document will reduce Create one form anxiety Standardized nursing role in advanced planning Disseminate advance directive information Self-Determination Natural Death Acts Patient self-determination involves the Natural death acts are written, legally right of individuals to decide what will or recognized advance directives but with will not happen to their bodies. statutory enforcement Competent adults have the right to Vary state to state forego treatment even if the refusal is Chapter 154 of the Wisconsin Statutes— certain death.
    [Show full text]
  • The Advanced Care Project (ACP): Case Studies from the Field
    THE ADVANCED CARE PROJECT Table of Contents Executive Summary ..................................................................................................................................... 2 Background .................................................................................................................................................. 3 Advanced Illness: Challenges and Responses .............................................................................................. 4 Advanced Care: Creating a New Continuum of Care ................................................................................... 4 The Advanced Care Framework ................................................................................................................... 8 A. Guiding Principles ................................................................................................................................ 8 B. Advanced Illness Metrics ................................................................................................................... 11 C. Population Definition ......................................................................................................................... 13 D. Care Delivery Structure and Process ................................................................................................. 17 E. Next Steps: Payment Model and Quality Metrics .............................................................................. 23 APPENDIX ..................................................................................................................................................
    [Show full text]
  • Frequently Asked Questions VHA Handbook 1004.02: Advance Care Planning and Management of Advance Directives
    Updated June 26, 2018 Frequently Asked Questions VHA Handbook 1004.02: Advance Care Planning and Management of Advance Directives 1. Q: Where can I find the VA advance directive form? A: The VA advance directive can be completed in iMedConsent™ or on paper. The paper form is available on the National Center for Ethics in Health Care’s website: http://www.ethics.va.gov/activities/policy.asp 2. Q: Who can access iMedConsent™? A: All staff members who have access to CPRS can access iMedConsent™. The program launches from the CPRS tool drop down menu. 3. Q: Can we alter or adapt the VA Form 10-0137 to include additional questions? A: No. VA Form 10-0137 (the VA advance directive) is approved by White House Office of Management and Budget, and it may not be customized by the facility. The Veteran completes the form by marking the check boxes and filling in information into the free-text areas and signing it, but the form itself may not be altered or customized. 4. Q: Can we include standardized, boilerplate text in the free text areas of the VA advance directive in iMedConsent™? A: No. Including standardized, boilerplate text in the free text areas would constitute altering or adapting the advance directive. Patients should determine what, if any, information is included in the free text areas in iMedConsent™. 5. Q: Does the VA recognize and honor non-VA advance directives? A: Yes. VA recognizes and honors throughout its health care system any valid VA advance directive, any State-authorized medical or mental health advance directive that is valid in one or more States under applicable State law, and any valid DOD advance directive.
    [Show full text]
  • A Pan-Canadian Framework January 2020 Acknowledgements
    Advance Care Planning in Canada A Pan-Canadian Framework January 2020 Acknowledgements The Advance Care Planning (ACP) in Canada Pan-Canadian Framework was developed with input from over 300 stakeholders and was reviewed by the following bodies: National Advance Care Planning in Canada Task Group: Cari Hoffman Earl Campbell Laurie Anne O’Brien Fraser Health Authority Earl G. Campbell Consulting Palliative Care Nurses Interest Group of Canada Chad Hammond Helena Sonea Canadian Hospice Palliative Canadian Cancer Society Rachel Carter British Columbia Centre for Care Association John You Palliative Care Charlie Chen Trillium Health Partners / Canadian Society of Palliative McMaster University Sharon Baxter Canadian Hospice Palliative Care Physicians Kathie Paddock Care Association Doris Barwich Health Canada, Advance Care Planning — End-of-Life Care Unit Tracy Sutton Alberta Health Services ACP-I (Canadian)Board Kim Jakeman & Lisa Corrente Member Canadian Bar Association, Health Law Section ACP in Canada Capacity Building Project Advisory Committee: Alyson Hillier Eman Hassan Laurel Gillespie Retired Teachers Organization, British Columbia Centre Canadian Hospice Nova Scotia for Palliative Care Palliative Care Association Cari Borenko Hoffmann Jessica Simon Maryse Bouvette Fraser Health Authority ACP CRIO Program / l’Association québécoise University of Calgary de soins palliatifs (AQSP) Chad Hammond Canadian Hospice Julie Darnay Nadine Henningsen Palliative Care Association Hospice Palliative Care Ontario Canadian Home Care Association Colleen Cash Kathie Paddock Nova Scotia Hospice Health Canada, Sharon Baxter Palliative Care Association End-of-Life Care Unit Canadian Hospice Palliative Care Association Doris Barwich Kim Jakeman & Lisa Corrente British Columbia Centre for Canadian Bar Association, Sharon Kaasalainen Palliative Care (2018–2019) Health Law Section McMaster University Advance Care Planning in Canada (Speak Up) extends its sincere gratitude and appreciation for all those who shared their wisdom, time and expertise to develop this document.
    [Show full text]
  • Advance Care Planning
    CONCISE GUIDANCE TO GOOD PRACTICE A series of evidence-based guidelines for clinical management NUMBER 12 Advance care planning NATIONAL GUIDELINES February 2009 Clinical Standards Department Guideline Development Group The aim of the Clinical Standards Department of the Royal Lead authors: Simon Conroy, Premila Fade, Aileen Fraser, Rebekah Schiff College of Physicians is to improve patient care and healthcare provision by setting clinical standards and The guideline development group: monitoring their use. We have expertise in the Mrs Jane Buswell development of evidence-based guidelines and the Consultant Nurse, British Geriatrics Society organisation and reporting of multicentre comparative Mr Simon Chapman performance data. The department has three core strategic Ethical and legal affairs advisor, National Council for Palliative Care objectives: to define standards around the clinical work of physicians, to measure and evaluate the implementation Dr Simon Conroy Senior Lecturer/Geriatrician, British Geriatrics Society of standards and its impact on patient care, and to effectively implement these standards. Dr Judi Edmans Research Occupational Therapist, University of Our programme involves collaboration with specialist Nottingham societies, patient groups and national bodies including the Dr Premila Fade National Institute for Health and Clinical Excellence (NICE), British Geriatrics Society Ethics SIG the Healthcare Commission and the Health Foundation. Mrs Aileen Fraser Consultant Nurse, British Geriatrics Society Concise Guidance to Good Practice series Dr Ann Homer GP, Royal College of General Practitioners The concise guidelines in this series are intended to Mrs Margaret Hughes inform those aspects of physicians’ clinical practice which Lay representative, Royal College of Physicians Patient may be outside their own specialist area.
    [Show full text]
  • Advance Care Planning in Aged Care: a Guide to Support Implementation in Community and Residential Settings Contents
    Advance care planning in aged care: A guide to support implementation in community and residential settings Contents Acknowledgement 4 Background 5 What is advance care planning? 5 What is an Advance Care Plan? 5 What is an Advance Care Directive? 6 Other types of written plans 6 What is a substitute decision-maker? 6 The role of the substitute decision-maker 7 Benefits of advance care planning 8 Advance care planning and aged care 8 Legislation: states and territories and interstate recognition 9 Non-statutory Advance Care Plans 13 Clinical care plans 13 Witnessing of documents 13 Legislation: practical considerations 13 Systems and governance 15 How to incorporate advance care planning into governance 15 Policies and procedures 16 System to alert, store, retrieve and progress advance care planning documentation 18 Quality improvement and audit processes 19 Staff education and support 21 Why educate staff about advance care planning? 21 Information to include in staff education 21 Legislation related to advance care planning 24 Advance care planning and dementia 25 Advance care planning, person-centred care and diversity 25 Format of education 26 Allocated time 29 Advance care planning in aged care: A guide to support implementation in community and residential settings Page 2 of 56 Consumer engagement 30 Education and support for the person and their family 30 Having the conversation 31 Barriers to having the conversation 31 Developing an Advance Care Plan 32 Diverse populations 32 Living with dementia 34 Living with an intellectual
    [Show full text]
  • Advance Care Planning in the Elderly
    UCSF UC San Francisco Previously Published Works Title Advance care planning in the elderly. Permalink https://escholarship.org/uc/item/8m40n1p0 Journal The Medical clinics of North America, 99(2) ISSN 0025-7125 Authors Lum, Hillary D Sudore, Rebecca L Bekelman, David B Publication Date 2015-03-01 DOI 10.1016/j.mcna.2014.11.010 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Advance Care Planning in the Elderly a,b, c d,e Hillary D. Lum, MD, PhD *, Rebecca L. Sudore, MD , David B. Bekelman, MD, MPH KEYWORDS Advance care planning Advance directives Surrogate decision maker Patient-doctor relationship Communication KEY POINTS Advance care planning (ACP) can help individuals and their loved ones receive medical care that is aligned with their values, and experience more satisfaction and peace of mind. ACP involves a process identifying personal values first, and then translating those values into medical care plans. ACP can be viewed as a health behavior that involves multiple steps and evolves as a process over time. Clinicians can assist older adults with ACP through assessing readiness, promoting iden- tification and documentation of appropriate surrogate decision makers, engaging patients and surrogates in discussions, and helping patients document their medical wishes. Outpatient approaches to support ACP can be brief, multidisciplinary, and involve several visits over time. INTRODUCTION Advance care planning (ACP) allows individuals to specify in advance how they want to be treated should serious illness prevent them from being able to make decisions or communicate their choices. Just as tobacco cessation counseling could be consid- ered a primary care provider’s “procedure,” engaging patients and their potential sur- rogate decision makers in ACP is a key skill in the care of the older adult.
    [Show full text]
  • Recommendations for Advance Care
    European Heart Journal (2020) 0, 1–11 CURRENT OPINION doi:10.1093/eurheartj/ehaa614 Recommendations for advance care planning in adults with congenital heart disease: a position Downloaded from https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa614/5898837 by guest on 30 August 2020 paper from the ESC Working Group of Adult Congenital Heart Disease, the Association of Cardiovascular Nursing and Allied Professions (ACNAP), the European Association for PalliativeCare(EAPC),andtheInternational Society for Adult Congenital Heart Disease (ISACHD) Markus Schwerzmann 1*, Eva Goossens 2,3, Pastora Gallego 4, Adrienne H. Kovacs 5, Philip Moons 2,6,7, Lorna Swan8, Daniel Tobler 9, Noe´mi de Stoutz10, Harald Gabriel11, Matthias Greutmann12, Jolien W. Roos-Hesselink13, Piotr Z. Sobanski 14, and Corina Thomet 1,2 1Center for Congenital Heart Disease, University Hospital Inselspital, Department of Cardiology, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland; 2Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, box 7001, 3000 Leuven, Belgium; 3Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, Division of Nursing and Midwifery, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; 4Department of Cardiology, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n. 41013 Seville, Spain; 5Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN-62 Portland, Oregon, USA; 6Institute of Health
    [Show full text]
  • An Introduction to Advance Care Planning in Practice
    BMJ 2013;347:f6064 doi: 10.1136/bmj.f6064 (Published 21 October 2013) Page 1 of 6 Clinical Review CLINICAL REVIEW An introduction to advance care planning in practice 1 2 Anjali Mullick consultant in palliative medicine , Jonathan Martin consultant in palliative medicine 1 3 1 and visiting fellow , Libby Sallnow specialty registrar in palliative medicine and research fellow 1St Joseph’s Hospice, London E8 4SA, UK ; 2Newham University Hospital, London, UK; 3Harris Manchester College, University of Oxford, Oxford, UK Advance care planning has been defined as a process of formal What are the benefits of advance care decision making that aims to help patients establish decisions 1 planning? about future care that take effect when they lose capacity. It recently gained increased importance in the United Kingdom, Theoretically, the process can facilitate patient autonomy so after being recommended by the end of life care strategy.2 The that patients’ future wishes can be carried out once they can no first national guidance for health and social care staff in the UK longer decide for themselves,1 but evidence regarding real was produced in 2007 and revised in 2011.3 Before this, terms benefit is mixed. A controlled trial of the impact of combining and concepts used in the UK had included “living wills” and improved communication about resuscitation preferences with “advance directives,” which have been replaced by terminology information on prognosis found no improvement in the quality outlined in the national guidance and the Mental Capacity Act of end of life care.12 Other authors have suggested that the wider 2005.4 advance care planning process may also be ineffective in 13-16 Advance care planning differs from general care planning in achieving positive outcomes.
    [Show full text]
  • Advance Care Planning for Individuals Experiencing Homelessness
    i n F O C U S A Quarterly Research Review of the National HCH Council Volume 4, Issue 2 | June 2016 Advance Care Planning for Individuals Experiencing Homelessness In the United States and other industrialized countries, increased risk of developing chronic diseases and rates of disease and mortality are high among those geriatric symptoms—“conditions that occur in older experiencing homelessness.(1-3) In addition, the number adults and cross discrete disease categories” (e.g., of older adults without homes is expected to increase to cognitive impairment, falls, and depression).(12-14) 95,000 by 2050.(4) This growth is evident in Health Care for the Homeless programs, which have already seen a The number of older adults 51% increase in the number of patients age 50 or older experiencing homelessness is between 2008 and 2014.(5,6) With these changing demographics coupled with poor health, there is a expected to increase to 95,000 by growing need for advance care planning (ACP) for this 2050 population, given its potential to prevent unnecessary suffering and to support an individuals’ preferences A lack of permanent housing, competing priorities related to care at end-of life.(7) This issue of In Focus associated with homelessness (e.g., food, shelter, and provides a synthesis of recent literature on advance care safety), high-risk behaviors (e.g., smoking and substance planning among individuals experiencing homelessness. use), and barriers to health care services add to the It gives an overview of morbidity and mortality of the complex challenges in managing these health issues. homeless population, their concerns about death, This may lead to further decline in overall health and advance care preferences, and implications for practice ultimately result in a shortened lifespan and high and policy.
    [Show full text]
  • Cross-Cultural Considerations in Promoting Advance Care Planning
    Cross-Cultural Considerations in Promoting Advance Care Planning in Canada Andrea Con, Ph.D Research Investigator CIHR Cross-Cultural Palliative NET This report was prepared for the Palliative and End-of-Life Care Unit, Chronic and Continuing Care Division, Secretariat on Palliative and End-of-Life Care, Primary and Continuing Health Care Division of the Health Care Policy Directorate, Health Canada (Contract Reference Number 4500150490). The views expressed herein do not necessarily represent the official policy of Health Canada. Printed February 2008. Layout and design by Melissa Friesen. Please direct inquiries to: Andrea Con, Ph.D. Research Investigator CIHR Cross-Cultural Palliative NET BC Cancer Agency Cancer Rehab/Sociobehavioural Research Centre #600 - 750 West Broadway Vancouver, BC Canada V5Z 1H5 tel: (604) 877-6098 ext. 3258 fax: (604) 708-2091 email: [email protected] Cross-Cultural Considerations in Promoting Advance Care Planning in Canada Prepared for Health Canada by: Andrea Con, Ph.D. Research Investigator CIHR Cross-Cultural Palliative NET November 2007 Table of Contents Advanced Care Planning in Canada TABLE OF CONTENTS Acknowledgements....................................................................................................................... iv Highlights..................................................................................................................................... vi Executive Summary......................................................................................................................
    [Show full text]