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ADVANCED HEALTH CARE DIRECTIVES

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					ADVANCED HEALTH
CARE DIRECTIVES

Kelsey Trail Health Region
Palliative Care Committee
Goal:
   Regional implementation of a standardized
    policy and procedure for Advanced Health
    Care Directives
KTHR Policy

   The Kelsey Trail Health Region Palliative
    Care Policy Manual was distributed to
    facilities in June 2006. A policy on
    Advance Care Directives is contained in
    Section 6, policy 50-10
KTHR Policy
 Advanced Care Directives are recognized
  as an important aspect of client care
  throughout the region
 The Region, where requested by a client,
  will provide information to that client to
  assist him/her in the completion of an
  Advanced Care Directive
KTHR Policy:
   All Kelsey Trail Health Region staff will
    respect client direction as outlined in the
    client’s Advanced Care Directive
        What is an Advanced Care
                Directive?
   It is a legal document that gives the Doctor or other
    Health Care Provider directions about what kind of
    measures are acceptable to you when you can no longer
    communicate what you want.
   The Directive must be made when you are capable of
    making a health care decision – it is too late once you
    become incapable.
   A lawyer is not needed to complete a directive
What to include in a Directive
 Give specific directions regarding certain
  treatments and situations
 Name another person to make decisions
  when you cannot communicate those
  decisions yourself. This person is known
  as a “Proxy”.
 Directives may include instructions for
  donating organs or tissues
 Health care Providers should be aware of
  the ethnic and religious guidelines for
  organ/tissue donation.
               This is not a Will!!
   A Health Care Directive deals only with a person’s
    wishes for health care when they are no longer able to
    communicate their choices.
   A Will deals with the disbursement of property after
    death
   Directives should be accessible to Health Care
    Providers. People are advised to bring them into the
    hospital if they are admitted.
   Sometimes a person may carry a wallet card or be
    wearing a medic-alert bracelet or necklace that indicates
        where the Directive is located and who to contact in
                 an emergency.
Who can make a Health Directive?


   Anyone who is 16 years of age and is
    capable of making health care decisions.
    When does a Directive apply?


   Only when a person is unable to
    communicate their wishes about their
    care.
              What is a Proxy?
   Is a substitute decision maker, at least 18 years
    old, who can be appointed to make health care
    decisions when a person is unable to
    communicate for themselves.
   A proxy does not mean that the person has
    power of attorney unless they have also been
    designated by the person to manage their
                 financial affairs.
      Statutes of Saskatchewan
   Health Care Directives and Substitute
    Health Care Decision Makers Act became
    effective September 1997
   The Act identifies that if a Proxy is not named,
    the nearest relative who is willing, available and
    has the capacity to make a health care decision,
         will act in that capacity.
   The order of the nearest relative as defined in
    the Act:
     Spouse   (or has co-habited as a spouse in a
      relationship of some permanence)
     Adult son or daughter
     Parent or legal guardian
     Grandparent
     Adult grandchild
     Adult uncle or aunt
     Adult nephew or neice
   If there are no family members, or the family
    members cannot be found, then your doctor or
    other Health Care Provider will make decisions
    for you by consulting another Doctor or Health
    Care Provider. The second Doctor must agree
    in writing that the proposed treatment is needed.
   Discord among family members may challenge
    Health Care Providers in the absence of a health
    care directive or because a directive is unclear
    or has not been communicated to the family.
     Can changes be made to a
            Directive?
 Changes can be made at any time, either
  orally or in writing
 The proxy should be notified about any
  changes
 Family members and the family Physician
  should have copies of the Directive
                   Directives
   Many examples of Health Care Directives are
    available on the Internet, through Lawyers, and
    at hospitals and special care homes
   Clients with Health Care Directives will have the
    front of their charts flagged with a red sticker.
   Health Care Providers should read the Directive
    to ensure they are clear about the person’s
               directions.
                  Family Peace
   Having a Directive
     Helps   relieve stress on the family in times of crisis
     Solves family disputes about what to do when one
      member is ill
     Relieves possible feelings of guilt because decisions
      are already made by the ill person
     Family members who don’t want heroic measures
      may be viewed as uncaring by other family members
      if there is no directive stating a preference
 This can cause problems and may prevent
  the ill person from getting the care they
  might choose
 Choices made when a person is well avoid
  discord in times of crisis
   People are reminded to be prepared

   Name a Proxy

   Complete a Directive

   Communicate their Wishes
Final Credits
   Public Legal Education Association of
    Saskatchewan
     www.plea.org