A GUIDE TO ADVANCE CARE PLANNING

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1 A GUIDE TO ADVANCE CARE PLANNING Advance Care Planning is a process that ensures your family and treating healthcare team understand what is important to you and how you want to be treated if you become unable to make decisions or communicate your wishes. Advance Care Planning can include: A. Appoint a substitute decision maker a Medical Enduring Power of Attorney for medical treatment decisions C. Chat and communicate talk to your family, friends and doctors about your healthcare preferences P. Put it on Paper Write down your preferences It s time to share the way you want to live at the end of your life and communicate about the kind of care you do and don t want for yourself. When it comes to making medical decisions for you, one conversation can make all the difference.

2 A. Appoint a substitute decision maker a Medical Enduring Power of Attorney for medical treatment decisions What would happen if you became very sick and couldn t make your own decisions? Who would make medical decisions for you? Would they know what you would want? It is a good idea to think about who you would want to make decisions about your health if you are unable to make these decisions for yourself. Think about; Someone who knows and respects your values and beliefs. Someone who is able to make decisions during stressful times. Someone you trust and will put your interests before their own. It is important that you talk to this person and tell them your preferences regarding future medical treatment. You can legally appoint this person to make these medical decisions for you and they will become your Medical Enduring Power of Attorney. For more information on appointing a Medical Enduring Power of Attorney refer to the Medical Enduring Power of Attorney Fact Sheet and the Guidelines for completing a Medical Enduring Power of Attorney. Or go to the Office of the Public Advocate website for more information.

3 C. Chat and communicate talk to your family, friends and doctors about your healthcare preferences It s not easy to talk about how you want the end of your life to be. But it s one of the most important conversations you can have with your loved ones. We know that no single conversation can cover all the decisions that you and your family may face. What a conversation can do is provide a shared understanding of what matters most to you and your loved ones. This can make it easier to make decisions when the time comes. The following questions might help you get your thoughts together so that you are ready to have the conversation with your loved ones. Start by thinking about what s most important to you. What do you value most? What can you not imagine living without? ( Relationships with my family and friends are very important to me, being independent is important to me and I would prefer not to have to rely on others for all my care ) What matters to me.. Use the scales below to think about your feelings and preferences. As a patient I only want to know the basics I want to know as much as possible How long do you want to receive medical care? I want to live as long as possible no matter what Quality of life is more important to me than quantity I m worried that I won t get enough care I m worried that I ll get overly aggressive care I wouldn t mind being cared for in a nursing home Living independently is a huge priority for me

4 It might help to think about situations that you would find unacceptable or too burdensome in relation to your healthcare. How would you feel if your quality of life resembled any of the situations listed below? I can no longer recognize family/ friends I can no longer talk or be understood by others. I permanently rely on a breathing machine to keep me alive. I am bed bound in a nursing home and require assistance with all my care. I can no longer walk and need someone to push me in a wheelchair. Difficult but acceptable Life like this would be Worth living but just barely Not worth living Can t answer now Scenarios It is helpful to think about quality of life circumstances where you would prefer more comfort care over active medical treatment. Imagine the following: You have advanced dementia and require full assistance for showering, dressing and toileting. You are unable to feed yourself. You develop a bad chest infection that turns into pneumonia. The doctors say that unless you have antibiotics to clear the infection, you will die. What kind of treatments would you want or not want in this situation? Everything on offer Provide all life prolonging treatments on offer including surgery, intensive care, Cardio Pulmonary Resuscitation (CPR) to cure illness and save your life. Some treatments but not everything Provide limited life prolonging treatments (including antibiotics) to reverse illness but no surgery, intensive care or CPR. Comfort care only Treat any distressing symptoms with pain relief and medication, do not provide life prolonging treatments, and allow death to occur. You are in hospital with an incurable cancer and your heart stops beating (cardiac arrest). What kind of treatments would you want or not want in this situation? I do not want Cardio Pulmonary Resuscitation if my heart stops beating. Let me die naturally. I would want Cardio Pulmonary Resuscitation attempted if medically appropriate.

5 P. Put it on paper Write down your preferences You can write down your wishes regarding future medical treatments in an Advance Care Plan. Advance Care Plan The Advance Care Plan is designed to guide your substitute decision maker, your family and your doctors to make medical treatment decisions if you can no longer do so for yourself. The Advance Care Plan has a number of questions for you to answer. The questions you thought about in the previous section should help you complete the document. You may need to chat to your doctor or another healthcare professional about some of the questions. Refusal of Treatment Certificate Medical treatment for a current medical condition can be refused by signing a Refusal of Treatment Certificate. You need to complete this with your doctor. What to do with the documents (Medical Enduring Power of Attorney, Advance Care Plan, Refusal of Treatment Certificate) Once you have completed your advance care planning documents it is important to ensure that they are signed correctly. We suggest that your GP is involved in signing your documents as they are concerned in your medical care and can confirm that you are making an informed decision and are of sound mind. Sharing your advance care planning documents It is important to share your advance care planning documents with your Medical Enduring Power of Attorney, family and your doctors. If you wish to register your documents with Alfred Health, you can do so by sending them to the Advance Care Planning Office (address listed over the page). Reviewing or cancelling advance care planning documents You might want to review or cancel your advance care planning documents in the future if there is a change in your personal or medical circumstances. You can change or cancel these documents by drawing a line across the document, writing void on it and signing and dating it. It is also important to inform your substitute decision maker, family and your doctors of the changes and provide them with copies of your new documents.

6 Would you like help with Advance Care Planning? If you would like help with competing advance care planning or you would like some more information you can contact the Alfred Health Advance Care Planning program. Phone: Address: Advance Care Planning Office Caulfield House, 260 Kooyong Road Caulfield VIC 3162 For more information or to download documents visit our website: