Advance care planning is not about decisions. It is about preparing you, and your future substitute decision maker(s), for a time when you may not be able to make your own health or personal care decisions because of your lack of mental capacity. At that time, your future SDM would step in to give or refuse consent for treatment.
You make your own decisions about any health care as long as you are mentally capable – that is, as long as you have the ability to understand and appreciate information relevant to making that decision
Sample scripts and workflow
…..I think the approach for family doctors who know their patients should be different than the approach from ER doc or specialist. Our strongest therapeutic tool is our relationship with our patients. I have made discussions with my patients COVID specific. Start by saying I am calling because I am concerned about them (or their family member for those who are POA for someone with cognitive impairment). Explain that they are in a high risk group and what this means and why it is important to have discussions now with all family and not just POA. I tell everyone “we all hope for the best but we need to plan for the worst”. To date, every patient/family member that I have called has thanked me for the call and indicated they will have the discussion. The conversations have averaged 5-10 minutes. Several commented they have been thinking about these issues but no one had actually had the conversation with family members.
EVERYONE knows and is talking about this. There are a dozen opportunities in every conversation it seems to plug this in. Ex. “You seem really worried about this virus. Sometimes planning ahead makes people feel less anxious. Have you ever thought about what you would want/do if you were to get really sick?
Staff of any kind can complete using the patient’s words and voice. Then making sure it had captured it as they wish. Then signing.
The first 2 are important, not the last.
I could see this all being done on screen and then save to the record, then print for patient and family and anyone else.
I guess that would mean making a note that it was done. That’s the flow I would do but I think anything could work.