This document discusses advance healthcare directives (AHDs) in Ireland. It notes that only 6% of people in Ireland have written an AHD. It defines AHDs as documents where a person can write down medical treatments they do not want if they lose decision-making capacity. For an AHD to be legally binding, the person must have had capacity when writing it and it must apply to their current medical situation. The document outlines the requirements for making a valid AHD in Ireland and implications for healthcare professionals, including that they have no liability for complying with a valid AHD or not complying if there are doubts about its validity.
Principles of Health Informatics: Informatics skills - communicating, structu...Martin Chapman
Principles of Health Informatics: Informatics skills - communicating, structuring, and questioning. Last delivered in 2023. All educational material listed or linked to on these pages in relation to King's College London may be provided for reference only, and therefore does not necessarily reflect the current course content.
Care of terminally ill patient full chapter fundamental of nursing pinkijat
Care of terminally ill patient,include concept of loss,grief , grieving,types of losses,type of grief,factors influencing loss and grief ,stage of grief and losses(DABDA) ,sign of clinical death,care of dying patient , palliative and hospice care, advance directive,legal documents related to advance directive,and after death care in fundamental of nursing full chapter.
Generally parents have the autonomy to make health care decisions for their child . In certain situations older children have autonomy to give assent to care& in special situations adolescents are granted a autonomy to consent without parents knowledge.
The American Hospital Association presents A Patient’s Bill of Rights with the expectation that it will contribute to more effective patient care and be supported by the hospital on behalf of the institution, its medical staff, employees, and patients. The American Hospital Association encourages health care institutions to tailor this bill of rights to their patient community by translating and/or simplifying the language of this bill of rights as may be necessary to ensure that patients and their families understand their rights and responsibilities.
Principles of Health Informatics: Informatics skills - communicating, structu...Martin Chapman
Principles of Health Informatics: Informatics skills - communicating, structuring, and questioning. Last delivered in 2023. All educational material listed or linked to on these pages in relation to King's College London may be provided for reference only, and therefore does not necessarily reflect the current course content.
Care of terminally ill patient full chapter fundamental of nursing pinkijat
Care of terminally ill patient,include concept of loss,grief , grieving,types of losses,type of grief,factors influencing loss and grief ,stage of grief and losses(DABDA) ,sign of clinical death,care of dying patient , palliative and hospice care, advance directive,legal documents related to advance directive,and after death care in fundamental of nursing full chapter.
Generally parents have the autonomy to make health care decisions for their child . In certain situations older children have autonomy to give assent to care& in special situations adolescents are granted a autonomy to consent without parents knowledge.
The American Hospital Association presents A Patient’s Bill of Rights with the expectation that it will contribute to more effective patient care and be supported by the hospital on behalf of the institution, its medical staff, employees, and patients. The American Hospital Association encourages health care institutions to tailor this bill of rights to their patient community by translating and/or simplifying the language of this bill of rights as may be necessary to ensure that patients and their families understand their rights and responsibilities.
The concept of advance care planning outlined. The Assisted Decision Making (Capacity) Act 2015. Using Think Ahead as a tool to engage with advance care planning and with advance healthcare directives
This guide is designed to help health and social care professionals understand and implement the law relating to advance decisions to refuse treatment (ADRT) contained in the Mental Capacity Act (2005).
This 2013 version replaces that published in September 2008 and covers:
How to make an advance decision to refuse treatment, who can make an advance decision, when a decision should be reviewed and how it can changed or withdrawn
What should be included
Rules applying to advance decisions to refuse life sustaining treatment and how they relate to other rules about decision-making
How to decide on the existence, validity and applicability of advance decisions and what healthcare professionals should do if an advance decision is not valid or applicable
The implications for healthcare professionals of advance care decisions, including situations where a healthcare professional has a conscientious objection to stopping or providing life-sustaining treatment
What happens if there is a disagreement about an advance decision.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Legal aspects of aging slideshareversionmargigould
Presentation to MD3 (3rd year Doctor of Medicine), ERC (Extended Rural Cohort) students at the Rural Health Academic Centre in Shepparton planned for Wednesday 12/2/2014 on legal aspects of ageing covering capacity, powers of attorney, advance care plans, advance health directives, elder abuse, fitness to drive, prognostic guidance
Start the Discussion: The Importance of Advance DirectivesSummit Health
We will discuss the importance of planning ahead about end-of-life decisions, provide useful information about how to prepare advance directives, and distribute sample forms.
Explores palliative and end of life care. Outlines advance care planning and provides information about planning ahead to include using advance healthcare directives
Reflections on the National Summary of Patient Activity Data for Adult Specia...Irish Hospice Foundation
IHF reflections on MDS data in relation to specialist palliative care services. Reflections offered on SPC beds, access to SPC services. This presentation highlights inequities that exist.
Final Journey’s is a staff development workshop for Acute Hospital Staff which raises awareness regarding quality of care at end of life.
Final Journeys was developed by the Irish Hospice Foundation as part of its Hospice Friendly Hospitals programme in 2010.
The workshop is now eight years old and is due for updating and review to ensure the content of the workshop is relevant and fresh.
Presentation of findings of an audit carried out on the nurses for night care service over a 6 month period that identifies the components of care that support people with dementia to die at home in Ireland
Stephen Toft - Programme Officer Palliative Care, HSE Primary Care Division, specialist palliative care minimum data set acute hospital figures 2016 and 2017 per hospital.
Deirdre Shanagher, IHF: Patient Involvement demonstrates the value and unique voice of people and values patients as the real experts in understanding their unique journey. It also helps empower patients.
Karen Charnley: Patient engagement - encourage and provide service user, carer and community engagement within the context of AIIHPC's work and the work of the wider palliative care community on the island of Ireland. Will inform and influence palliative care education, research, policy and practice, in a collaborative and supportive manner.
Emer Carroll, National Health & Safety Manager, National Health and Safety Function, Workplace Health and Wellbeing Unit, presents on HSE Workplace Stress Management.
The Mater Misericordiae University Hospital and St. James’s Hospital and their academic partners UCD and TCD surveyed bereaved relatives about their experience of end-of-life care in hospital. Results reveal the high standard of care provided in both hospitals and further indicate where improvements could be made to enhance the care experience.
Dr. Hanna Linane - Disturbing and Distressing - The Tasks and Dilemmas Associ...Irish Hospice Foundation
Determines the frequency with which SHOs deal with tasks and dilemmas associated with end-of-life care and evaluates the impact of patient death on their psychological well-being.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
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Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
2. Today:
• Advance Care Planning (ACP)
• Advance Healthcare Directives (AHD)
• Implications for health and social care professionals
• Questions
3. In Ireland:
Only 6% of people have
written an AHD
Irish Attitudes to Death, Dying & Bereavement (2014)
National representative sample of 891 people
4.
5.
6. Advance Care Planning –What is
it?
Voluntary discussions over time about future care
Process not task – may be more than one conversation
When we know things may change
When we know decision making in the
future may be difficult
7. Oct 30th 09 ST/AON
What might be included in ACP
discussions
Spiritual
8. Guidance for healthcare professionals:
• Always presume decision making capacity
• Help the person to maximise their decision making
capacity
• Remember that the person with dementia can choose
not to take part in the advance care planning process
• Be aware of how to assess a persons decision making
capacity if required to do so
• Gain knowledge on what steps to take if decision
making capacity is an issue
• Check existing advance care plans with the person
regularly for validity and applicability
9.
10.
11. Advance Healthcare Directives (AHD):
• A document where a person can write down what they
would not like to happen in relation to certain medical care
treatments
• Only comes into force when a person loses capacity,
becomes ill and the circumstances in their AHD arise.
12. Legal status of AHDs:
• Case law: Irish Supreme Court in Re a Ward of Court (No 2)
[1996]2 IR 79 – AHDs are recognised by Irish law, provided
that the author was competent and that the directive was
specific to the patient’s current situation
• Irish Medical Council Guide to Professional Conduct & Ethics
(8th Ed 2016) Section 16.2: …. An AHD has the same status as
a decision by a patient at the actual time of an illness and
should be followed provided that:
• the request or refusal was an informed choice, in line with the
principles in paragraph 9;
• the decision covers the situation that has arisen; and
• there is nothing to indicate that the patient has changed their mind.
13. Legal status of AHDs:
• NMBI Code of Professional Conduct for Registered
Nurses & Midwives (2014): An AHD should be respected
on condition that:
• the person made an informed choice regarding their decisions at
the time of making the plan;
• the decision in the directive covers the situation that has now
arisen;
• there is no indication that the person has changed their mind since
the advance care directive or plan was made.
• Part 8 of the ADMA (2015) – legislative provisions for
AHDs
14. Making an AHD:
• Must be 18 years or older
• Must have capacity at the time the AHD is being made
• Must be made voluntarily
• Documented to include name, DOB & contact details
(video & voice recording acceptable)
• Be signed by 2 witnesses who are over 18, one of which
is not a member of the directive makers immediate family.
Each witness is to observe the directive maker signing the
AHD.
• If appointing a DHR: He/she to be a witness and DHR
details to be documented also (name, DOB & contact
details)
17. Issues that may be covered in an AHD:
• Treatments that a person would refuse in the future – this is legally
binding – even if deemed unwise, not based on sound medical principles or will
result in death
• A request for a specific treatment. This is not legally binding but should be
taken into consideration during any decision-making process which relates to treatment
for the person in question if that specific treatment is relevant to the medical condition for
which the person may require treatment.
18. What makes an AHD legal?
• The person had decision making capacity at the time
they made the advance healthcare directive.
• The advance healthcare directive was made voluntarily.
• The advance healthcare directive was not altered or
revoked.
• The person who made the advance healthcare directive
did not do anything inconsistent with the terms of the
advance healthcare directive while they had decision
making capacity.
19. When will an AHD come into effect?
• Only comes into force when a person loses capacity,
becomes ill and the circumstances in their AHD arise.
• AHD is NOT applicable if:
• The person has capacity to consent to or refuse treatment
• The treatment is not materially the same as specified in the AHD
• The circumstances for the AHD to apply are absent
• Re life sustaining treatment; if the AHD does not state that it is to
apply even if the directive makers life is at risk
• The refusal in the AHD relates to “basic care”
20. Uncertain re AHD?
• Consult with the DHR (if one appointed) or family and
friends
and
• Seek opinion of a second health and social care
professional
• If ambiguity remains; resolution in favour of preserving the
directive makers life
21. Implications for healthcare:
• If there are grounds to believe a treatment refusal in an
AHD is valid & applicable – no civil or criminal liability
• If belief that AHD is not valid & applicable and AHD not
complied with – no civil or criminal liability
• No civil or criminal liability if at time in question:
• There were no grounds to believe an AHD existed
• There was no immediate access to the AHD
22. Designated Healthcare Representative:
• A person(s) appointed by a directive maker to act on their
behalf in relation to healthcare decisions when they lack
capacity
• They are responsible for ensuring an AHD is complied
with
• They can be specifically appointed
• to advise and interpret the directive makers will & preferences
• to consent/refuse treatment
• (with reference to the AHD)
• Must keep a written record of decisions taken and present
for inspection at request of the directive maker or DSS
23. Designated Healthcare Representative:
• The DHR:
• Must not be convicted of an offence
• Must not be the owner or registered provider of a residential facility
or mental health facility where the directive maker lives
• Must not be a provider of personal or healthcare services to the
directive maker for compensation
• Complaints re DHR can be made to the DDSS who can
investigate
24. Draft codes of Practice:
• Section of ADMA commenced to allow for HSE
multidisciplinary group to be established to make
recommendations re codes of practice to the DDSS
• Codes of practice in development
• AHD multidisciplinary working group established (prepare
recommendations for code of practice for AHDs)
• Consultation closed May 4th 2018
• When approved will be published by DDSS
• Codes will be admissible in legal proceedings
• DDSS will establish & maintain a register for AHDs
Presuming covered under the functional approach to capacity
Broader than healthcare
Submissions to the forum indicated wanting info on handling financial affairs and speaks to Prevention of Elder abuse
You don’t have to complete all of the document
The difference between an ACP and AHD is the refusal and legal binding with refusing treatments.
I’d like to acknowledge these people and will now take some questions if there are any.