Advance Care Planning

To view this presentation as a webinar with sound visit CLEONet http://www.cleonet.ca/training CLEONet is a web site of legal information for community workers and advocates who work with low-income and disadvantaged communities in Ontario. www.cleonet.ca

About our presenter… Judith Wahl has been the Executive Director and Senior Lawyer at the Advocacy Centre for the Elderly (ACE) since 1984. ACE is a community legal service for low income seniors that focuses on legal issues that have a greater impact on the older population. Judith has organized and taught numerous public legal education programmes on legal issues that arise in day to day work with seniors, including Advance Care Planning - Physicians’ Training Ontario College of Family Physicians and Alzheimer Society of Ontario; Gerontology Programme at McMaster University, Faculty of Social Sciences; the Diversity Training Course at C.O. Bick Police College; as well as Continuing Legal Education Programmes for the Law Society of Upper Canada, Ontario Bar Association, the former Canadian Bar Association – Ontario, and the Canadian Bar Association National.

Health Care Consent and Advance Care Planning - Getting it Right Part I – Health Care Consent Basics Part II- Advance Care Planning Judith Wahl, B.A., LL.B. Barrister and Solicitor Advocacy Centre for the Elderly [email_address] Advoccacy Centre for the Elderly 2010

Advocacy Centre for the Elderly Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Today’s Webinar Part 2 of 2 Health Care Consent and Advance Care Planning - Getting it Right Part 2 – Advance Care Planning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Webinar Part I of 2 Health Care Consent and Advance Care Planning - Getting it Right Part I – Health Care Consent Basics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Questions during Webinar ,[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Legislation ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Treatment Decision Making ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

What is Valid Consent? ,[object Object],Advoccacy Centre for the Elderly 2010

What is Informed Consent? Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Relationship between Consent and Advance Care Planning (ACP) ,[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Wishes are not consents ,[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Treatment in the future is NOT necessarily ACP ,[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Decisions can be for present care and care in the future ,[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Advance Care Planning Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object]

Advance Care Planning ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Advance Care Planning ,[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Advance Care Planning Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Problems of Advance Care Plans Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object]

Advoccacy Centre for the Elderly 2010 Hospice Palliative Care Conference 2009

Guide to Advance Care Planning ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Questions? ,[object Object],Advoccacy Centre for the Elderly 2010

Rules for ACP ,[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Options for Advance Care Planning Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Wishes Expressed Orally Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Written Wishes Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Written Wishes Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Written Directives Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

DNR Confirmation Form ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

DNR Confirmation Form ,[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Who does the ACP speak to? Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object]

SDM’s Role – CONSENT, not ACP ,[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

How SDMs Make Substitute Decisions Advoccacy Centre for the Elderly 2010 It is the responsibility of the SDM to make treatment decisions for an incapable person by: a) following any wishes of the patient expressed when capable that are relevant to the decision; and b) if no wishes are known or are relevant to the particular decision, to act in the best interests of the patient

Best Interests Definition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

What if the SDM seems not to be making health decisions in accordance with Patient’s Express wishes? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Health Practitioner and Conflict with SDMs Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Health Practitioner and Conflict with SDMs ,[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Applications to Consent and Capacity Board Advoccacy Centre for the Elderly 2010 ,[object Object],[object Object],[object Object],[object Object]

Questions? ,[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Scenario 1 - What Does the Nurse do? ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Scenario 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

CONSENT, not ACP ,[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Advoccacy Centre for the Elderly 2010 Time ACP is about planning in “advance” for future situations Discussions about CPR occur in “advance” Advance Care Plan Wrong! Logic?

Advoccacy Centre for the Elderly 2010 Time Discussions about CPR happened and consent was acquired A current Plan of Treatment was revised Plan of Treatment Simplistically Right!

Scenario 2 – Is this a Consent? Is this an ACP? How is it Used? Should it be Used? Why is it Used? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Scenario 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

If Mrs Smith is Capable with Respect to Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

If Mrs Smith is not Capable to Make Treatment Decisions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

If Mrs Smith is Not Capable to Make Treatment Decisions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Consent to Plan of Treatment ,[object Object],Advoccacy Centre for the Elderly 2010

Summary ,[object Object],[object Object],[object Object],Advoccacy Centre for the Elderly 2010

Questions ,[object Object],Advoccacy Centre for the Elderly 2010

2010, Community Law School (Sarnia-Lambton) Inc. This webinar was brought to you by CLEONet For more information visit the Health and Disability section of CLEONet at www.cleonet.ca For more public legal information webinars visit: http://www.cleonet.ca/training

Advance Care Planning

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Advance Care Planning