Advanced Care Planning in the Geriatric Population
| Nanette Lavoie-Vaughan, M.S.N., APN |
Course Description:
The role of advanced care planning in the geriatric population is
essential for preparing not only for the end of life but for crises that
occur as a normal part of the aging process and co-morbid medical
conditions. DNR status and advanced directives are discussed on
admission to a nursing facility or on yearly office visit. However,
advanced care planning involves much more. Patients and their
families need to discuss wishes for end of life care, comfort
measures and make decisions regarding what treatment options
they want initiated. In order to make an informed decision they
must have an understanding of the trajectory of their specific
illness. This program will utilize the Evercare model for presenting
a comprehensive approach to guiding patients and their families
through the advanced care planning process. It will discuss the
concepts of the illness trajectory and provide scripts for
discussing specific medical conditions. An advanced directive tool
will be introduced that incorporates treatment choices,
values/wishes, understanding of disease/conditions, goals of care
and comfort measures. A role playing case study will be presented
to illustrate the concept of advanced care planning.
Objectives:
At the completion of this program, the participant will be able to:
1. Define common terminology used in advanced care planning.
2. Define the illness trajectory and be able to discuss 3 specific illnesses.
3. Define the components of the advanced directive.
4. Script a family discussion to include all the components of an
advanced care plan.
Outline:
1. Common Terminology
A. Health care surrogate/POA
B. Living Will
C. Advanced directive
D. Out of facility DNR
E. Comfort care
2. DNR status
A. Forms
B. State regulations
C. Documentation
3. Advanced Directives
A. Treatment options
B. Values/Wishes
C. Comfort care
4. Illness Trajectory
A. Dementia
B. Diabetes
C. Cardiac disease
D. CVA
E. Renal disease
F. COPD
5. Scripts for discussion
A. Advanced directives
B. Dementia
C. Medical conditions
D. End of life
6. Contingency planning
A. What ifs
B. Pros and cons of treatment
C. Hospitalization
7. Resources
A. Hospice
B. End of life care initiative
The role of advanced care planning in the geriatric population is
essential for preparing not only for the end of life but for crises that
occur as a normal part of the aging process and co-morbid medical
conditions. DNR status and advanced directives are discussed on
admission to a nursing facility or on yearly office visit. However,
advanced care planning involves much more. Patients and their
families need to discuss wishes for end of life care, comfort
measures and make decisions regarding what treatment options
they want initiated. In order to make an informed decision they
must have an understanding of the trajectory of their specific
illness. This program will utilize the Evercare model for presenting
a comprehensive approach to guiding patients and their families
through the advanced care planning process. It will discuss the
concepts of the illness trajectory and provide scripts for
discussing specific medical conditions. An advanced directive tool
will be introduced that incorporates treatment choices,
values/wishes, understanding of disease/conditions, goals of care
and comfort measures. A role playing case study will be presented
to illustrate the concept of advanced care planning.
Objectives:
At the completion of this program, the participant will be able to:
1. Define common terminology used in advanced care planning.
2. Define the illness trajectory and be able to discuss 3 specific illnesses.
3. Define the components of the advanced directive.
4. Script a family discussion to include all the components of an
advanced care plan.
Outline:
1. Common Terminology
A. Health care surrogate/POA
B. Living Will
C. Advanced directive
D. Out of facility DNR
E. Comfort care
2. DNR status
A. Forms
B. State regulations
C. Documentation
3. Advanced Directives
A. Treatment options
B. Values/Wishes
C. Comfort care
4. Illness Trajectory
A. Dementia
B. Diabetes
C. Cardiac disease
D. CVA
E. Renal disease
F. COPD
5. Scripts for discussion
A. Advanced directives
B. Dementia
C. Medical conditions
D. End of life
6. Contingency planning
A. What ifs
B. Pros and cons of treatment
C. Hospitalization
7. Resources
A. Hospice
B. End of life care initiative
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