Calgary Zone 403 9430249 httpwwwalbertahealthservicescaadvancecareplanningasp myvoicealbertahealthservicesca Advance Care Planning Goals of Care Calgary Zone Advance Care Planning is a process that involves ID: 1045003
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1. Advance Care Planning: Goals of CareCalgary Zone(403) 943-0249http://www.albertahealthservices.ca/advancecareplanning.aspmyvoice@albertahealthservices.ca
2. Advance Care Planning: Goals of Care - Calgary ZoneAdvance Care Planning is a process that involves: Thinking about values and wishes regarding future health care choices;Learning about medical information that is relevant to health concerns, understand prognosis, potential degrees of benefit and possible burdens; Choosing an agent and communicating wishes and values to your agent, loved ones, and health-care providers, and;Documenting wishes and values and sharing these documents with your agent, loved ones, and health-care providers.
3. Who needs to engage in Advance Care Planning? Everyone. You never know when you may face an unexpected event or illness and will be unable to make your preferences known.
4. Health-care decision-making can be very complex. It may be easier to make decisions when you have thought about and shared your values and beliefs ahead of time.Advance care planning and completing a personal directive can ease the burden on your loved ones by helping them understand your wishes so they can confidently speak on your behalf, should you be unable to do so.Why should I consider Advance Care Planning?
5. Why should I consider Advance Care Planning?According to Statistics Canada:248,000 Canadians die each year In 2020 this number will have increased to 330,000 According to the Canadian Hospice and Palliative care Association : Up to 50% of persons cannot make their own decisions at the end of life (CHPCA)Health professionals typically treat when uncertain of treatment wishesHospitals remain the major provider of EOL care as 70% of Canadians die in a hospital with one in five of these hospitalized deaths occurring in an ICULoved ones have a significant chance of not knowing a person’s view without discussion
6. Why should I consider Advance Care Planning?Current Research demonstrates: The absence of Advance Care planning is associated with worse patient and family ratings of quality of life in the terminal phase of illness .Conversations are difficult for everyone Those who have end of life conversations with loved ones and health care professionals:Require fewer aggressive medical interventions at the end of lifeAre more likely to take advantage of relevant resources at end of lifeSurviving family feel less of a burden with decision making and have reduced suffering/distress in times of bereavement.
7. Advance Care Planning: Goals of Care Designation (Adult) Policy Calgary and AreaWhat do you know about your health condition?Do you know the treatment decisions you may need to make in the future? What procedures would you want/not want if you were to have a medical emergency?If you have a medical condition:
8. Planning DocumentsThe court would only award guardianship or trusteeship if a person was incompetent, and had not written a Personal Directive or an Enduring Power of Attorney. For more information go to http://www.seniors.alberta.ca/opg* Graphic used with permission by the Office of the Public GuardianDecisions made by you…Decisions made by the court…while you are alivePersonal DecisionsPersonal DirectiveAgentCo-Decision-makingCo-decision MakerSupported Decision AuthorizationSupporterGuardianshipGuardianFinancial DecisionsEnduring Power of AttorneyAttorneyTrusteeshipTrustee…after deathFinancial AssetsWillExecutorIntestate Succession ActAdministrator
9. Advance Care Planning: Goals of Care Designation (Adult) Policy Calgary and AreaTo speak on your behalf, who:Is at least 18 years old Will respect your values, beliefs and goalsCommunicates well with family and healthcare providersAgrees to be your representative (This person would be called your Agent if you name them in your Personal Directive) Choose someone…
10. Document your preferences…in a Personal Directive.Give copies to: Your AgentYour healthcare providersYour familyOthersAsk them to bring your documents to the hospital if you are admitted.
11. What documents have you completed? (Personal Directive, “My Voice” workbook, Enduring Power of Attorney, Will)Have you given copies of your documents to those people who should have them? (physicians, Agent, family, friends, etc.) When is the last time you reviewed these documents? Do they need to be updated? Are there any changes you want to make?Preparing your documents
12. your advance care plan:When there is a change in your health statusWhen there is a change in your treatment locationWhen new information is availableAnnuallyReview and revise…
13. Goals of CareA Goals of Care Designation is a letter/number code that provides direction regarding specific health interventions, transfer decisions, locations of care, and limitations on interventions for a patient as established after consultation between the Most Responsible Health Professional and Patient.
14. Goals of CareHealth care goals established through Advance Care Planning conversations between the individual, family and any members of the health care team. Align appropriate medical interventions with individual wishes and values.
15. Goals of CareConversations’ Core Elements Diagnosis and prognosis Individual’s values, hopes, and expected outcomes Life support interventions and life sustaining measures and anticipated degree of benefit and/or burden Comfort measures Decision support resources such as social work, spiritual care, and palliative care Goals of Care Designation
16. Goals of CareClinician’s PerspectiveCure of a condition to restore functioningControl of a condition in order to maintain functionAlleviation of symptoms, such as pain or discomfort
17. Goals of CareIndividual’s PerspectiveWhat are my hopes for the treatments being considered?What are the benefits and burdens of a treatment?How do my values, goals and beliefs impact my decision for: Living as long as possibleHaving better quality of lifeBeing independentControlling symptomsWhere to be cared for
18. Goals of CareEngage in Goals of Care ConversationMedical condition prognosisIndividual's values and hopesLife support interventions, life sustaining measures and degree of benefitComfort measuresDecision supportGoals of Care Designation
19. Advance Care Planning: Goals of Care - Calgary ZoneR Medical Care and Interventions including Resuscitation followed by ICUM Medical Care and Interventions, excluding ResuscitationC Medical Care and Interventions, focused on ComfortDiagnosisPrognosisAnticipated OutcomesWishes and ValuesLife Support / Life Sustaining BenefitsComfort MeasuresResourcesCure or control of condition with option for resuscitationCure or control, no resuscitationAlleviate the symptomsProcess of arriving at a Goals of Care Order
20. Advance Care Planning: Goals of Care - Calgary Zone
21. Goal of Care - RR1 - Patient is expected to benefit from and is accepting of all appropriate interventions and investigations including resuscitation and ICU careR2 - Patient is expected to benefit from and is accepting of all appropriate interventions and investigations including resuscitation and ICU care with the exception of chest compressionsR3 - Patient is expected to benefit from and is accepting of all appropriate interventions and investigations including resuscitation and ICU care with the exception of chest compressions and intubation
22. Goal of Care – M M1 – Interventions are for cure or control of illness excluding ICU and Resuscitative care. Transfer to hospital considered if required for diagnosis and/or treatmentM2 – Interventions are for cure or control of illness, excluding ICU and Resuscitative care. Transfer to Acute care and/or surgical intervention not generally undertaken for acute deterioration but may be considered in special circumstances to better understand or control symptoms.
23. Goal of Care – CC1 – Maximal symptom control and maintenance of function with cure or control of underlying condition. Transfer and/or surgery to better understand or control symptoms. C2 – Physical, psychological and spiritual preparation for imminent death. Maximal efforts directed at compassionate symptom control. Transfer usually not undertaken.
24. Goals of CareA Goals of Care Designation Order is reviewed: Acute Care: every 30 days. LTC/DAL/HC: every 12 months. If patient is transferred between health care teams If there is a significant change in health status. At the request of the individual or representative.
25. Questions? For more information: Call us at (403) 943-0249Visit our website: http://www.albertahealthservices.ca/advancecareplanning.aspEmail us at: conversationsmatter@albertahealthservices.ca