Presenter Disclosure/Commercial Support

Nanci Corrigan, Communications Strategist, Speak up Campaign•No relationship with commercial interests

The Speak Up Campaign is financially supported by:•GlaxoSmithKline Foundation•Canadian Hospice Palliative Care Association

Disclosure Of Commercial Support

– I have received no commercial support to participate in this session.

– There is no potential for conflict of interest.

Mitigation Of Potential Bias

• I have received no commercial support for this session and none of the commercial sponsors of the overall conference were involved in the content development of this session.

Did you know?

6/10 Canadians think it’s important to talk about wishes for end-of- life care

But…

Only 45% have

And…

39% are ‘creeped out’ by the conversation

“What Canadians Say: The Way Forward Survey Results” (Harris/Decima 2013)

!!?

What about YOU?

• Do you have an advance care plan?• If yes, how did you get started?• If no, why not?• How do we break down the barriers

and get the conversation started?

Research tells us:Canadians with an advance care

plan are more engaged in the health care system – 90% of

them have a family physician or regular place of care

Patients who have end-of-life conversations with their doctors and family members are much more likely to be satisfied with their care, will require fewer aggressive interventions at the end of life, place less of a strain on caregivers and are more likely to take advantage of hospice resources or

die at home.

“I don’t have enough information about his condition, what to

expect and how long he has. I am trying my best but I don’t have a

medical background and I am alone in all this decision-making

and feel overwhelmed.” -ACCEPT study participant

Without a conversation…

Without a conversation…..

“I didn’t expect him to die so soon. My husband resisted talking about dying and after 40 years of marriage I feel he let me down by not opening up and I guess I let him down for not knowing how to talk about some of the things that I needed to discuss. It would have been nice closure if things had been different in the end. I can never get that time back.”

-CANHELP study participant

Or without clarity …

“I didn’t know what he (the MD) was saying when asking me in the ER…. do I want CPR. “He asked with no explanation. I said sure if it works. He put down YES on the form but then told me it probably wouldn’t work and I would have brain function problems. Good God! I don’t want that! Give me the information first, then ask the questions.”

ACCEPT study participant

What about health care professionals?

“I think one of the things that’s important

is we go into this profession and, you

know, doctors it’s all about [how] we need to fix things and we need

to, you know, cure things. That’s kind of the mindset we have.

And we sometimes lose sight of the fact that we

can’t actually fix everything.”

- ON Physician,

Decisions affect everyone…

 ”I asked the charge nurse about an 86-year-old woman who had been recently admitted for non-Hodgkins Lymphoma. …the charge nurse’s eyes filled with tears as she told me that today wouldn’t be a good day, as the patient was scheduled for a bone marrow biopsy…a painful procedure that wasn’t going to give any more information about stage of the disease, as a CT scan had shown that her disease had spread throughout her peritoneum and chest…”-Research Assistant

Whose decision?

“I had a patient who was very ill and she was still full resuscitation code and I started to see that she was really deteriorating and struggling with the treatment and not in a lot of comfort… I actually talked to the residents quite a few times saying ‘I really don’t think she’s coming out of this. Is it time to talk about her level?’ and they said ‘No, I think we can fix this.’ -Alberta Nurse  

It can happen to anyone…

“My mother became ill quite quickly - and even though I had seen so many families go through this before, I never truly understood how devastating it could be. Looking back, I now realize how important it is to plan ahead and be prepared for the future.”

- Ashley Horton26 year old Emergency Nurse

What’s your story?

I’ve got a plan I’ve named a Substitute Decision Maker I’ve shared my plan with family / my health

team

Or….

are you creeped out?

Let’s Talk…

• Have you thought about your values and wishes?

• Have you chosen a Substitute Decision Maker?

• Have you talked with others about your wishes?

If yes, tell us about itIf no, why not?

Professional discussions?

• Have you had these discussions as part of your career?

• What was the reaction from others?• How did the experience affect you and

others involved?

Let’s get started….

• What can individuals and families do?• What can health care professionals do?• What can organizations do?• How can you become an ACP

Champion?

Make your own plan

Help others make a plan...

Our “Just Ask” conversation card has tips for talking with family members about personal care wishes

Share the campaign

www.advancecareplanning.ca

•Workbooks•Posters/infographics•Decision Aids•Videos•Wallet cards/bookmarks•Event resources

Share Best Practices

• ACP Community of Practice

• Articles/blogs for your organizational website

Share your story

Be the change

As a person, health professional, member of an organization, how can

you get the conversation started?

Thoughts?

•How do you plan to implement what was shared and learned today into your personal and/or work life?

•How can we support you?

Maxine’s Advance Care Plan

I, MAXINE, being of sound mind and body, do not wish to be kept alive indefinitely by artificial means.

If a reasonable amount of time passes and I fail to ask for at least one of the following: glass of wine, chocolate, margarita, martini, cold beer, chocolate, chicken fried steak, cream gravy, Mexican food, French fries, pizza, ice cream, or a cup of tea, it should be presumed that I won’t ever get better.

When such a determination is reached, I hereby instruct my appointed person and attending Physicians to pull the plug, reel in the tubes, and call it a day.

It’s about conversations.It’s about decisions.It’s how we care for each

www.advancecareplanning.ca

Thank you !