How Can a Certified Facilitator Help Me?

Having conversations about serious healthcare issues is tough. But the alternative can be even tougher… relying on your loved ones to make decisions about your care when you’re unable to speak for yourself is stressful.

Certified facilitators can assist you, your family and your loved ones engage in people-centered conversations that result in informed healthcare decisions. The decisions can be documented in advance directives that will guide your care if you’re unable to speak for yourself.

Certified Facilitators have skills in engaging people in important conversations about the things that are most important to them.

They help one explore one’s understanding of advance care planning, their fears and concerns, experiences and living well.

They can assist in the selection and preparation of one’s healthcare representative.

They help identify cultural and/or spiritual beliefs that may impact decision making

They can help one identify goals of care for a severe, permanent brain injury

They can assist one in completing an advance directive document

Schedule Your Free Appointment Today

Advance Care Planning Process Tools

Are you ready to get started? Great! If you’d like an Honoring Choices® Indiana – North Central certified facilitator to help you, you can contact us to schedule an appointment. Even if you aren’t yet ready, you may want to take a moment to get familiar with the resources that are available to Indiana residents to help with advance care planning. The link below provides directions and forms.

Advance Directive Form

Download Forms

 

MYTHS & FACTS

Myth #1 – I’m young and healthy, so I don’t need advance directives

Fact – every adult needs advance directives. In fact, younger, healthy adults may need them even more. If they have a serious accident or disease, they may be kept alive, in a vegetative state, for years. Young adults should, at the very least, appoint a healthcare representative.

Myth #2 – You must use your state’s forms in order for your advance directives to be followed

Fact – most states only require that certain witnessing and signature procedures be followed, and that you are of sound mind.

Myth #3 – Talking to my doctor and family about my healthcare wishes isn’t legally effective

Fact – letting your doctor and family know what you want is the most important step to take. These conversations, in addition to your completed advance directives, will help guide your care if you can’t speak for yourself.

Myth #4 – Once I’ve filled out my advance directives and spoken with my doctor, family and healthcare representative, I’m done

Fact – we advise that you revisit your advance directives periodically to make sure they still accurately reflect your wishes. You can use the “D” strategy – take a look at them after experiencing one of the following life events:

• Death of a loved one

• Divorce

• Diagnosis

• Decline

• Decade birthday

Myth #5 – Having advance directives means that I don’t want any treatments

Fact – advance directives tell your doctor and healthcare representative what you want and don’t want. Even if you don’t want curative treatment, you should receive treatment for pain and symptoms.

Terms

Advance care planning
a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care.

Advance directives
your instructions (both spoken and written) about the type of medical treatment you would want if you were unable to speak for yourself. Your advance directives can indicate the person you choose to make health care choices and decisions for you if you’re unable to do so. They can also indicate what types of treatments you do – and do not – want to receive.

Artificial hydration and nutrition
the use of nutrients and/or fluids through a tube placed in the digestive tract or into a vein that supplements or replaces eating and/or drinking.

Cardiopulmonary resuscitation
medical procedures that restart the heartbeat and breathing. It may include pressing on the chest to cause blood to circulate, inserting an airway into the mouth or throat or inserting a tube into the windpipe, artificial ventilation, the use of drugs to stimulate the heart and/or defibrillation (electric shock) to restart the heart.

Health care representative
the person you choose to receive health care information and make decisions on your behalf when you are unable to do so.

Hospice care
To treat a person’s symptoms from an illness and provide support to the patient and family. The person must have any progressive or incurable illness and a limited life expectancy, and the physician must certify a prognosis of six months or less if the disease follows its normal course.

Living will
a written document that outlines your wishes if you are terminally ill and can’t speak for yourself. It is an advance directive that lists specific treatments you want or don’t want during a terminal illness. Typically, it includes directions for cardiopulmonary resuscitation (CPR), artificial nutrition, maintenance on a respirator, blood transfusions and the use of antibiotics and other medications. Indiana law allows you to write one of two types of advance directives:

Living will declaration
this document tells your family and healthcare providers which specific life-prolonging treatments you wish to have as well as those you don’t want. For example, it may state that you do not want CPR but that you do want a feeding tube for nutrition.

Life-prolonging procedures declaration
this document is the opposite of a living will and can be used if you want all life-prolonging medical treatments used to extend your life.

Out of hospital do not resuscitate declaration and order
Indiana law allows a qualified person to say they do not want CPR provided if their heart or lungs stop working in a location outside a hospital.

Palliative care
To treat a person’s symptoms from an illness and provide support to the patient and family. The person must have any progressive or incurable illness and a limited life expectancy measured in months but not years and a physician must order admission.

Physician’s orders for life-sustaining treatment (POLST)
these are direct physician orders for a person that has: an advanced chronic progressive illness; or advanced chronic progressive frailty; or a condition caused by injury, disease or illness from which (to a reasonable degree of medical certainty) there can be no recovery and death will occur from the condition in a short period of time without the provision of life-prolonging procedures; or a medical condition that, if the person were to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful or that the person would experience repeated cardiac or pulmonary failure within a short period, resulting in death.

Statistics

  • The fastest growing population group is those who are 65 years of age or older.1
  • The 85+ age group will quadruple from 2000 to 2050.1
  • One in four Medicare dollars is spent on people who are in the last year of life.2
  • 77% of participants in an advance care planning study3 prefer a conversation about end-of-life wishes during a visit that covers other issues.

1 http://www.aoa.acl.gov/aging_statistics/future_growth/docs/by_age_65_and_over.xls

2 Health Services Research “Long-term Trends in Medicare Payments in the Last Year of Life,” April 2010.

3 Conversation Starters: Research Insights from Clinicians and Patients on Conversations About End-of-Life Care and Wishes (John A. Hartford Foundation https://www.johnahartford.org/images/uploads/reports/ConversationStartersFocusGroupsReportFINAL.pdf)