Advanced care planning presentation for Tiverton event 12 may v 4

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Advanced care planning presentation for Tiverton event 12 may v 4

  1. 1. Advance care planning
  2. 2. ••••
  3. 3. •••
  4. 4. Who’s who?
  5. 5. Background to Advanced Care Planning Hilary Squire Clinical Nurse Specialist Hospiscare
  6. 6. •••
  7. 7. ••••
  8. 8. ••••
  9. 9. ••
  10. 10.
  11. 11. ••••
  12. 12. References• The cancer Plan (DoH, 2000).• The Cancer Reform Strategy(DoH, 2007).• Advanced Care Planning: A guide for Health & Social Care Staff (2007) at: http//www.endoflifecareforadults.nhs.uk• The End of Life Strategy (DoH, 2008).• Dying Matters Coalition GP Project NCPC (2010) at http//www.dyingmatters.org
  13. 13. Strategies in Instigating an ACP Annie Hunneyball Clinical Nurse Specialist Hospiscare
  14. 14. •••
  15. 15. •••
  16. 16. Cancer High Function GP’s WorkloadAve 20 Deaths per GP per year Low Time Organ Failure High Function Low Time Fraility/Dementia High Function Low Time
  17. 17. •••
  18. 18. •••••
  19. 19. •••••••
  20. 20. •••••
  21. 21. •••••
  22. 22. References• Advance Care Planning: A guide for Health & Social Care Staff (2007) at :http// www.endoflifecareforadults.nhs.uk• Gold Standard Framework Prognostic Indicator Guidance (2008) at: http//www.goldstandardsframework.nhs.uk• The End of Life Strategy (2008) Department of Health, at: http//www.DoH.gov.uk
  23. 23. ADVANCED CARE PLANNING Caroline Prince Clinical nurse specialist Hospiscare
  24. 24. •••
  25. 25. •••
  26. 26. •••••••
  27. 27. •••
  28. 28. Advance Decision to Refuse Treatment Dr Jane Whitehurst Macmillan GP Facilitator for Exeter and Mid Devon Specialty Doctor Hospiscare
  29. 29. ••••
  30. 30. ••••••
  31. 31. •••••
  32. 32. ••
  33. 33. ••••••
  34. 34. ••••
  35. 35. Valid ADRT• I now have MND and benefit from PEG feeding. As my condition deteriorates, if I should lose consciousness and am not expected to recover after 24hrs, I wish feeding, hydration and any other life prolonging treatment such as antibiotics to be withdrawn or withheld although medication such as painkillers for my immediate comfort can be used. This decision to apply even if my life is at risk”
  36. 36. Valid ADRTsI wish to refuse the following In these circumstances:-specific treatments:-Artificial (mechanical) breathing If I have had a severe stroke withmachine little chance of recovering consciousnessAntibiotics If my dementia means that I cannot not make the decision, in the event that I have a severe chest infection that might threaten my life.Artificial feeding (via a tube or drip) When my dementia has deteriorated to the point that I cannot swallow safely, even with the help of others
  37. 37. •••••••
  38. 38. •• • •• or intentionally shorten a patients life
  39. 39. ••••••
  40. 40. ••••••
  41. 41. Core Competencies for ACP
  42. 42. ••••••
  43. 43. Last night, my husband and I were sitting in theliving room and I said to him, I never want to live ina vegetative state, dependent on some machineand fluids from a bottle’.He got up, unplugged the computer, and threw out mywine.
  44. 44. Mrs Adams•
  45. 45. Mr Brown•
  46. 46. Mrs Carter•
  47. 47. Mr Downham•
  48. 48. This is my favorite recipe. It was Grannys. Now you are the guardian
  49. 49. “This is a book that I am really going to miss. Think of me whenever you read it
  50. 50. Here is my favourite joke. Dad leftit to me, now you must keep it alive
  51. 51. Thank you for this memory. I treasure it.
  52. 52. I always wanted to tell you this but was too shy/afraid/embarrassed.
  53. 53. I can’t remember if I told you this before but.....
  54. 54. There is something I have learned that I would like you to know
  55. 55. If you watch this film, think of me. It was my favourite.
  56. 56. Have you ever thought abouttrying....I reckon you would be great at it

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