End of Life Care Flashcards
What is advance care planning?
A process for identifying and communicating an individual’s values and preferences regarding future health care
Why is ACP important?
It builds trust
Reduces uncertainty
Helps to avoid confusion and conflict
Permits peace of mind
What are some components of advance care planning?
Advance Directives:
- Living will
- Medical or Health care power of attorney (POA)
- Do not resuscitate (DNR)
What is a living will?
A written statement that expresses your wishes about medical treatment that would delay death from a terminal condition
When do living wills apply?
to situations of persistent vegetative state or irreversible coma
What is the Medical Power of attorney (MPOA)
A document lets you choose another person, called an “agent,” to make health care decisions if you can no longer make those decisions for yourself
Which component of ACP may not be available in all states?
POLST (Physician Orders for Life-Sustaining Treatment)
Who makes decisions about ACP?
the pt, if they have the capacity to do so
if not, check pts chart or file for an advance directive
Do all durable power of attorney documents cover health care decisions?
NO
What do you do if a pt is not capable of making health care decisions and does NOT have a advance directive?
clinicians will need to identify and select a surrogate medical decision-maker
- spouse
- adult child of pt
- parent
- domestic partner
- sibling
- close friend
- pts physician (need to consult ethics committee)
Who can’t/should be a surrogate decision maker?
the treating health care provider
employee of the treating health care provider (unless related
owner/admin/employee of pts health care facility
Always check your facility’s policy!
What resources are available to help pts with end of life planning?
the conversation project –> helps pts talk about end of life wishes
When should you review ACP documents with your pt?
upon a change in condition (and periodically) to ensure they continue to reflect the patient’s preferences
What is the clinician’s goal in in end of life care?
to elicit the patient’s goals and recommend treatments and discuss options consistent with those goals
What are the primary goals of end of life care?
Curative- tx underlying condition
Palliative-promote comfort by relieving pain and suffering
Combination
