Engage with Grace - A Critical Family Conversation

Watch this 10 minute video - you will be inspired to have conversations about your wishes for future care.


Check out the "Engage with Grace" website.

Are Canadians Ready to Talk About the Cost of Dying?

The Globe and Mail is doing a series of articles on end-of-life.
Today's article, "Are Canadians Ready to Talk about the Cost of Dying?" is worth reading.

Video Link - Planning Care for the Final Days

Watch this video as the BBC highlights the Respecting Choices® program at Gundersen Lutheran Hospital in La Crosse, Wisconsin.
Be prepared for a brief ad, not related to the topic, just prior to the actual news clip from the BBC.

Respecting Choices and Disease-Specific Advance Care Planning

Respecting Choices Disease-Specific Advance Care Planning: The Next Steps for Patients with Chronic Progressive Illness

Respecting Choices has a long history of developing advance care planning (ACP) programs that produce successful outcomes. For the past several years, they have been testing and refining an approach to ACP for patients with chronic, progressive illness called “Disease Specific - Advance Care Planning” (DS-ACP). Through research and clinical implementation, they have developed the expertise and strategies for successful replication.

Why is Disease Specific ACP Important?

• Millions of people live with—and eventually die from—a variety of chronic illnesses, experiencing sudden but predictable complications for which they are unprepared.
• Only one-third of patients with chronic, progressive illness have completed some type of written advance directive.
• Even when written plans are created and available, they are often not helpful because chosen healthcare agents are not prepared to make specific decisions (often choosing more aggressive treatment than their loved ones would choose) and instructions provided are too vague or ambiguous to guide clinical decision making when needed).
• The 2008 Dartmouth Atlas report identifies wide variability in care and related costs of patients with chronic, progressive illness in the last two years of life. This raises the concern that some patients might be receiving more interventions than they want or can benefit from.
• Patients with chronic, progressive illness report a need for information on treatment survival and outcomes in order to make informed healthcare choices. They also express a desire for information about treatment options, benefits, and burdens.
• The 2008 Report to Congress calls for a shift from advance directive completion to patient-centred communication strategies that assist patients in making informed healthcare decisions.

Find out more about Disease Specific ACP on the Respecting Choices website. Contact me or Matthew Isbell at the Gundersen Lutheran Medical Foundation: 800.362.9567  (Ext. 54747)

Conversation with Dave - what does it mean to be a burden to others?

In less than 10 minutes, Dave shared some significant information about his values and goals for living well. Take some time to watch this video as Dave thinks ahead to what it may be like in the last months and years of his  life.

http://www.youtube.com/watch?v=yMIWiP-8fA8

My husband Garth took this video with my Iphone a couple of days ago. We had been visiting with Dave and his wife Noni when a conversation over coffee prompted me to ask Dave if he would mind doing a "film version" of the conversation. With today's incredibly accessible technology, it's easy to make recordings like this.
Thank you, Dave, for being on-camera - I can sense a movie version coming.

Planning Care for the Final Days - Respecting Choices Program

This video was prepared for the BBC World News and gives a brief overview of the ground-breaking work in La Crosse, Wisconsin. I am on the faculty of Respecting Choices and I teach in Canada.
http://news.bbc.co.uk/2/hi/programmes/world_news_america/9402281.stm

New Incapacity Planning Legislation In Force in BC September 1, 2011

New Incapacity Planning Legislation In Force in BC September 1, 2011

Recognizing the Conversations

Advance Care Planning (ACP) conversations don’t typically appear with headings and paragraphs and categories. They appear in the midst of life – whether it be a brief aside during a movie, a comment about the importance of pets in our life, or significant words exchanged with family members during the healthcare crisis of another family member. These conversations can be short or long and can happen with individuals of any age or health status. Have a look at these statements – which of them fit into the category of ACP?
1. “This little dog is the best thing that ever happened to me. I often wonder how I got along without him.”
2. “I just can’t stand being in confined spaces.”
3. “Harry is in a nursing home now and they have to spoon feed him. Sheila cries every time she visits him – so much so that her kids wonder if they should limit her visits.”
4. “I think the idea of defibrillators in sports arenas is a great one. In fact, every time I go to a hockey game and pass the defibrillator on the wall, I feel good that help would be so close at hand.”
5. “I get the most pleasure out of seeing her smile and having her squeeze my hand.”
6. “I watched as her minister prayed with her. She seemed to get such comfort from that prayer. I hope someone will pray for me that way when I’m dying.”
7. “I have written out my wishes for future care on a piece of paper.”
Of course all of these comments have something to do with ACP. They communicate values and beliefs and concerns about health and general well-being. They aren’t legal documents, but they are important guidelines for delivering care to an individual when that individual is too ill to make decisions for themselves.
So let’s stop looking for formal conversations alone to guide us as we agree to treatment for and deliver care to our family members who can no longer decide for themselves. Let’s jot down snippets of conversations, let’s recall ways in which these individuals lived their lives, and let’s use this information to inform our decisions for them. The goal should be for us to do just what the person would have wanted us to do, in light of their values, goals, and beliefs.
Take a moment to view this brief commentary by Joanne Lynn, Bureau Chief for Chronic Diseases and Cancer in Community Health Administration of the Department of Health for Washington, DC. Joanne is a leader in ACP and sheds light on the breadth of these ACP conversations.
http://www.youtube.com/watch?v=OOH5hVQRxD4