My Wishes My Care Advance Care Planning Facilitators

My Wishes, My Care: Advance Care Planning Facilitator’s Name of the Organization Date and Time of the session

Welcome

Focus for today’s session: Advance Care Planning in British Columbia You will learn the what, why, who, when and how of planning for your future care.

Guidelines for discussion • • Respect other’s opinions. Respect other’s privacy. Share only if you want to. Please ask questions if you need more information. • Use the raise hand function. • Write your comment or question in the chat box. • Physically raise your hand on camera.

Zoom functions Raise Hand (participants menu) Chat Your name

Advance Care Planning is part of life planning

Where Advance Care Planning fits in the Life Planning Model?

Have you done some planning already?

What is Advance Care Planning? Advance Care Planning is a process of: • thinking about your values, beliefs, and wishes for future health and personal care, and • sharing them with the people you trust. It can include choosing who would make care decisions for you if you cannot. Advance Care Planning can help you get the care that’s right for you even if you are unable to speak for yourself.

Have you heard of the term “Advance Care Planning” before signing up for this session?

Why do you think Advance Care Planning is important?

Why might you do Advance Care Planning?

Discussion Break: Why people might do Advance Care Planning?

Benefits of Advance Care Planning For your family and friends For your health-care providers

Is Advance Care Planning different than you thought it was? Has anybody done some Advance Care Planning? What have you done so far?

Who should do Advance Care Planning?

When should we to do Advance Care Planning?

Advance Care Planning… • Part of life planning, for every adult • The sooner you start, the better • Advance Care Planning is voluntary. • Even if you’ve done Advance Care Planning, your health-care provider will always ask you to make decisions about your own care as long as you understand can communicate your wishes.

How to do Advance Care Planning?

Think: what matters most to you? Think about: • your personal values • your personal beliefs • your personal wishes Thinking about what matters to you informs your future health care decisions

Think: what matters most to you? • What makes a good day? • What activities or routines make your day more enjoyable? • What makes life meaningful? • How do you make decisions? • What cultural, religious or spiritual beliefs are important to you? • What does good quality of life look like for you? What does it include?

What to think about depends on what stage of life you’re in. All adults People who are older, frail, or living with a serious illness People who are approaching end of life

Seva – Selfless Service

Have you heard of the term “Substitute Decision Maker”?

Think: who could make decisions for you, if you cannot? Substitute Decision Maker Makes health and personal care decisions for you if you are not able to make them for yourself. Needs to know your: • values, beliefs and wishes • health conditions • care and treatment preferences and options

Think: who could make decisions for you, if you cannot? A good Substitute Decision Maker: knows you well will honor your wishes and instructions is calm in a crisis; can communicate with health-care providers • will always act in your best interests; and • can handle conflict or disagreement • •

Think: who could make decisions for you, if you cannot? Who comes to mind when you think of these questions? • Who knows what gives your life meaning, joy and purpose? • Who helps you with your health care? Who helps you with your personal care? • Who do you trust to respect your wishes and make decisions the way you would make them for yourself?

Why is it important to share what matters most to you with the people you trust?

Talk: to the people you trust Share: • what matters most to you • your fears and worries about your future health • any treatment decisions you already know • who will make decisions for you • how you hope that person will be supported

How might you prepare for and start a conversation about what matters most to you with your family and friends?

Talk: to the people you trust • • Prepare ahead of time Pick a relaxed time Choose a comfortable place Be gentle and go slowly Be open to learning and hearing Be open to more conversations Start by discussing the present

Talk: to the people you trust I was thinking about what happened to Ernie, and it made me realize… Right now, I’m healthy, but I want to think ahead and be prepared if something unexpected should happen… I just answered some important questions about my health-care wishes. I want you to see my answers, and I’m wondering if we can talk about them?

Talk: to your health-care providers

How might you prepare for and start a conversation with your health-care provider? Do you know what you would talk to them about?

Talk: to your health-care providers • Prepare ahead of time • why it is important for you to have the conversation • what you would like to achieve • which of your health-care providers you would like to talk to • Make an appointment • Invite someone you trust

Advance Care Planning… • Conversations are key! • Talk To: • The people you trust • Your health-care providers • The more conversations you have, the easier they get

Plan: Prepare an Advance Care Plan s and • Your values, wishe beliefs n • Substitute Decisio Maker(s) Optional: • Legal Forms

Why do you think making an Advance Care Plan is helpful?

Options for Substitute Decision Makers in Health Care Hierarchy of Medical Consent in B. C. Adapted from People’s Law School.

If you do nothing… Temporary Substitute Decision Maker • The law ensures you always have a substitute decision maker. • If you haven’t legally named a representative ahead of time, your health-care provider will follow the Temporary Substitute Decision Maker (TSDM) list.

Temporary Substitute Decision Maker List 1. Spouse (common law, any gender) 2. Child 3. Parent 4. Brother or sister 5. Grandparent 6. Grandchild 7. Anyone else related by birth or adoption 8. Close friend 9. A Person immediately related by marriage 10. Public Guardian and Trustee or another person appointed by them The person must be: 19 years of age or older, capable, have no dispute with you, and have been in contact with you in the past year.

Temporary Substitute Decision Maker List “ Who would be on your list? How do you feel about that? 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Spouse (common law, any gender) Child Parent Brother or sister Grandparent Grandchild Anyone else related by birth or adoption Close friend A Person immediately related by marriage Public Guardian and Trustee or another person appointed by them

Choosing a person as a Substitute Decision Maker Representation Agreement • A legal document completed by you as a capable adult. • Names one or more Representatives. • Can name one or more Alternate Representatives • You do not need a lawyer or notary. • You can specify which decisions they can make. • You can specify how they may act.

Representation Agreement Differences. Section 7 - Standard Section 9 – Enhanced Capable person Person with lessened capacity Personal care and health care decisions Personal care and minor and major health care decisions Cannot make decisions to refuse life support Includes decisions about life support & life prolonging treatments Cannot make financial decisions (can make an Enduring Power of Attorney) Provides for routine management of financial and legal affairs

Why Representation Agreements are helpful • If the Temporary Substitute Decision Maker list doesn’t work for you • If you want to choose exactly who your Substitute Decision Maker would be • For personal-care decisions • For consistency in care and decision making • In case of family conflict

Making decisions in advance Advance Directive • A legal document for accepting or refusing specific health-care treatments. • You must be capable to make an Advance Directive. • Your instructions must be honored, as long they address the treatment offered at the time. • Talk to your health-care provider before making an Advance Directive.

If you have both a Representation Agreement and an Advance Directive • Health-care providers will ask your Representative to make the decision* But • Your Representative legally must consider the instructions in your Advance Directive *Unless you state otherwise in your Representation Agreement

Plan: Prepare an Advance Care Plan our y f o n io t a t n e m u c o • D efs li e b & s e h is w , s e lu va n for io t a m r fo in t c a t n o C • orary p m e T l ia t n e t o p r u o y akers M n io is c e D e t u it t s b Su Optional: ent m e e r g A n io t a t n e s e r • Rep (Section 9) • Advance Directive

Have you made any of the Advance Care Planning legal documents? If not, are you planning to make any?

Plan: Share your Advance Care Plan • Keep documents together in a safe place where they can be found if needed • First responders check on or near the fridge • Share your plan with: o your Substitute Decision Maker o close family and friends o your health-care providers • Bring documents with you to the hospital

Review your Plan • Why? Our health, illnesses, treatment choices and life circumstances change. • When? • • • at least once a year when you have a change in health if your life circumstances change, e. g. your relationship with SDM • How? Think - Talk – Plan • Share updated documents

Advance Care Planning… • Part of life planning. • The sooner you start the better! • Three simple steps: Think, Talk, Plan. • It helps you get the care that’s right for you. • Conversations are key! • The more conversations you have, the easier they get. • Not a one-time event • As long as you are capable, you will make your own decisions

Final questions? Resources Do some Advance Care Planning over the next month Please complete our evaluation survey

THANK YOU!