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Advance Care Planning

A short course of lectures
«Advance Care Planning»

Religion, Spirituality, and Culture in Advance Care Planning III Implementing Advance Care Planning: Model Programs Personality Styles Associated With Decision Making Minimizing the Dying in Death The Institute of Medicine Principles and Advance Care Planning Progressive Dementia Reflection Compassionate Communication Challenges to Effective Advance Care Planning Nutritional Support Rational Knowledge Advance Care Planning and the Problem of Overtreatment Improvement Science Reflective Practice: Discovering Countertransference and Cotransference Universal Positive Change The Consumer Movement and Advent of Advance Directives CROSS-CULTURAL INFLUENCES AND ADVANCE CARE PLANNING Taking Comfort in Complexity BACKGROUND Underutilization THE IMPORTANCE OF RELIGION AND SPIRITUALITY IN ADVANCE CARE PLANNING Focus on Autonomy and Control Overview of Advance Medical Planning “To Err Is Human”: Building a Safer Health System ADVANCE CARE PLANNING IS PERSON-CENTERED Psychological Considerations Making Quality Improvement Difficult Cultural Considerations Advance Medical Care Planning: The Legal Environment Identifying Patients With Particular Needs: The Gold Standards Framework NATIONAL INITIATIVES The Coalition for Compassionate Care of California EDUCATION NURSING HOMES MULTIPLE CARE CONSIDERATIONS BY DOMAIN Professionalization Reliance on Experts A STORY OF BELIEF AND END-OF-LIFE CARE DECISION MAKING CPR The Importance of Local Leadership THE MAJOR KEY: RESCUE AS NATIONAL IDEOLOGY The Leadership Challenge Maximum Conservative Treatment and Care Advance Care Planning: Considerations for Practice With Older Adults THE IMPORTANCE OF CULTURE Passion, Persistence, and Pennies On Writing One's Own Advance Directive Problems With Advance Directives THE KNOWLEDGE SOCIETY AND THE CULTURE OF DECISION MAKING BEHAVIORAL CHANGE MODEL FOR PLANNING WHAT DOES ADVANCE CARE PLANNING ASK OF US?THE MINOR KEY: PALLIATIVE CARE, THE VIRTUES OF CLASSICAL CITIZENSHIP, AND A NEW END-OF-LIFE CONVERSATION Lack of a Seamless Health Care System Who Has the Time?Set the Agenda Advance Care Planning as a Public Health Issue Bad Death/Dying Poorly Arrhythmia Six Leadership Actions From Kabcenell and Conway Health Policy and End of Life (EOL) in the United States Advance Care Planning HONESTY AND HOPE Whose Role Is It Anyway?Hemiplegia V Selected Resources on Advance Care Planning and End-of-Life Care Preface Conversations That Matter: Stories and Mobiles THE PROBLEM OF OVERTREATMENT DEATH IS NOT THE ENEMY Barriers to Advance Care Planning: A Sociological Perspective How Is Information and Education Provided to Almost 30,000 Staff?MOBILES AND SHATTERED GLASS Bringing the Community Back In Financial Considerations JOURNALS Failure or Success?The Triple Aim A STAGED APPROACH TO ACP Difficulties in Deciding on Specific Treatments Ventilator / Respirator / Mechanical Ventilation / Breathing Machine PREDICTABLE CAREGIVING NEEDS OF PERSONS WITH DEMENTIA II Best Practices for Communicating About End-of-Life Care Let's Make a Deal: The Importance of Recognizing an Opportunity Policy Issues for Health Care Institutions THE COMMUNICATION REVOLUTION IN ADVANCE CARE PLANNING: A NEW PATH FORWARD Worlds of Connection: Applying an Interdisciplinary Relational Model of Care© to Communicating About End of Life The Role of Contemporary Nursing Homes Potential Benefits of Advance Care Planning STATE OR REGIONAL INITIATIVES The Longevity Revolution PUBLIC ENGAGEMENT RELIGIOUS PERSPECTIVES ON ADVANCE CARE PLANNING AND ADVANCE DIRECTIVES Prepare Identify Hope The Unasked Question PRIMARY FOCUS ON ADVANCE CARE PLANNING JUST TALK ABOUT IT CAN THE RESPECTING CHOICES MODEL BE SUCCESSFULLY REPLICATED?VALUES AND GOALS QUALITY IMPROVEMENT AND LEADING LARGE-SCALE CHANGE DISCUSSION OF THE ABOVE ADVANCE DIRECTIVE How Did We Get Here: A Brief History of Advance Care Planning Lack of Awareness About Advance Directives and Advance Care Planning Resident Health and Functional Status Characteristics PERCEPTIONS OF SUFFERING AT THE EOL Deskilling in the Knowledge Society DEALING WITH DARK EMOTIONS Improvement and the Institute for Healthcare Improvement RECONCEPTUALIZING PLANNING IN ADVANCE FOR CARE THE CONTEMPORARY LEGAL ENVIRONMENT A HEALTH PROMOTION AND COMMUNITY ENGAGEMENT CONTEXT FOR ADVANCE CARE PLANNING Normalize Feelings of Relief in Grief Determine Understanding of Illness COPING WITH THE REALLY BIG STORM REFERENCE Expanding Medical Technology Planning for End-of-Life Care: Where Are We and How Did We Get Here?The Ideology of Rescue UNCERTAINTY Jeopardy: The Importance of Asking the Right Question Deliver the Person With Dementia From Anonymity Ethical Foundations of Advance Care Planning CONFLICTS WITH “WESTERN” MEDICAL SYSTEM VALUES UNSPOKEN CLINICAL REALITIES: TRANSFERENCE, COUNTERTRANSFERENCE, AND COTRANSFERENCE Making Quality Improvement Easier SPIRITUAL ASSESSMENT AND ADVANCE CARE PLANNING The Centrality of Truth Telling or Parrhe–sia THE PROMISE OF ADVANCE DIRECTIVES Social Considerations Spiritual Considerations Aphasia Communication Challenges in the Nursing Home Setting BEYOND OBJECTIVITY, PATERNALISM, AND AUTONOMY THE PROFESSIONALS' OWN STORIES Terminal Condition Advance Directives ENGAGEMENT How Do You Reach the Physician Group and Move From a Curative Medical Model of Care?Kotter's Change Management Tools Lack of Health Care Provider Skills in Communication Complex Medical Characteristics of Nursing Home Residents Palliative Care Performing Illness SYSTEM INFRASTRUCTURE ACKNOWLEDGMENT BRIEF HISTORY Setting the Agenda Calculating Value ORGANIZATION OF THIS BOOK It Ain't Easy: Making Life And Death Decisions Before The Crisis Nondisclosure THE PUBLIC HEALTH ROLES OF DEATH EDUCATION IN SUPPORTING ADVANCE CARE PLANNING Quality Improvement in End-of-Life Care The Take Charge Partnership “Just Talk(s) About It:” A Model for Sustained Grassroots Activism LEADERSHIP AND GREAT TEAMS Effective Leadership WATCH OVER ME: THERAPEUTIC CONVERSATIONS Federal Laws Related to Advance Care Planning in Nursing Homes Brain Injury/Pathology When Great Teams Are Not Enough Dying for CPR Advance Care Planning and Nursing Home Residents and Families: Lessons Inspired by TV Game Shows The Importance of Nursing Home Staff THE CHALLENGE OF FACING DEATH FOR AMERICAN PUBLIC HEALTH WHY HAS THE RESPECTING CHOICES APPROACH TO PLANNING WORKED WHEN OTHER APPROACHES HAVE FAILED?Delivering Higher System Performance Reluctance to Talk About Death and Dying TRAJECTORIES OF DECLINE AT THE END OF LIFE The Social Support System of Nursing Home Residents Medical Considerations Identify Hope AUTONOMY AND INTERDEPENDENCE A SHIFT TO RELATIONALITY: APPLYING THE INTERDISCIPLINARY MODEL OF CARE Resource Development BOOKS Key Element #4: Continuous Quality Improvement Understanding Acknowledgments “The Quality Chasm”STEWARDSHIP, JUSTICE, AND PROFESSIONAL ETHICS I Advance Care Planning: Promise and Challenge Conflicting Autonomies Defining Advance Directives and Advance Care Planning Dying for CPR DISCUSSION: THE PROBLEM PHILOSOPHICAL UNDERPINNINGS Key Element #3: Community Engagement and Education Advance Care Planning: Focus on Communication and Care Planning Rather The Unasked Question Tailoring and Anticipatory Guidance Inspiring Improvement and Leading Change DISCUSSING RELIGIOUS AND SPIRITUAL ASPECTS OF ADVANCE CARE PLANNING COMPASSION IN THE CLINICAL RELATIONSHIP The Attack on Professions Does the Nation's Survival Depend on a New End-of-Life Conversation?State the Obvious Respecting Choices: An Evidence-Based Advance Care Planning Program With Proven Success and Replication Wheel of Fortune: Don't Count on Controlling Everything Policy and Medical Orders CONTINUOUS QUALITY IMPROVEMENT ACHIEVING IDENTITY Watch Over Me: Therapeutic Conversations in Advanced Dementia OTHER Maximum Conservative Treatment and Care Advance Care Planning and Trying to Get Well COMING TOGETHER INFLUENCE OF THE LEGAL ENVIRONMENT ON END-OF-LIFE CARE AND ADVANCE MEDICAL PLANNING OVERCOMING CHALLENGES FUTURE THE SICK ROLE WHAT CAN WE LEARN ABOUT ACP IN THE NURSING HOME FROM TV GAME SHOWS?THE NEXT STEPS IN ADVANCE MEDICAL PLANNING Storing and Retrieving POLST Forms Physical Considerations Create the Space PLANNING FOR ENDINGS Key Element #2: Advance Care Planning Facilitation Skills Education and Training CASE STUDIES The POLST Paradigm Defined HOPE, DEATH, AND COMMUNICATION: REFLECTIONS THAT INFORM THE IRMOC THE MEETING OF SPIRITUALITY, RELIGION, AND CULTURE Heroic Support Discussion THE GOALS OF ADVANCE CARE PLANNING ARE DEFINED IMPLEMENTING LARGE-SCALE CHANGE CULTURAL DIVERSITY From Product to Process: From Advance Directives to Advance Care Planning Normalize Feelings of Relief in Grief APPLYING THE PRINCIPLES OF WATCH OVER ME IV Systems Level Change: Charting a New Path for Dying, Death, and End-of-Life Care HOW IS THE RESPECTING CHOICES APPROACH TO ADVANCE CARE PLANNING DIFFERENT FROM THE TYPICAL APPROACH TO ADVANCE DIRECTIVES?DEATH AND DYING THE CHALLENGE OF PLANNING FOR END OF LIFE NATURAL PROGRESSION OF DEMENTIA BACKGROUND Key Element #1: Designing Systems to Support Advance Care Planning HOW PUBLIC HEALTH CONTEXTS ADDRESS CHALLENGES AND BARRIERS TO ADVANCE CARE PLANNING SETTING THE STAGE DEVELOPMENTAL DISABILITIES THE PROCESS OF ADVANCE CARE PLANNING INVOLVES UNDERSTANDING, REFLECTION, AND DISCUSSION Palliative Care and the Virtues Experts and Routine Activities Tailoring and Anticipatory Guidance History of the Problem OPPORTUNITIES FOR DECISION MAKING AND ADVANCE CARE PLANNING BELIEF, PAIN, AND ADVANCE CARE PLANNING ESTABLISHING OUR IDENTITY YOUR WISH, MY COMMAND: FINDING SOLACE IN ADVANCE DIRECTIVES The Legal Environment of Advance Care Planning Hospice Good Death/Dying Well ASSETS OF THE NURSING HOME SETTING REFLECTIONS ON LIFE AS WE WORK WITH OTHERS Great Teams High Spinal Injury PROFESSIONAL ASSOCIATIONS DEFINING RELIGION AND SPIRITUALITY DISCUSSION Reforming Ideology, Reforming Worldview, Reforming Health Care OUR EVOLVING FAMILY STORIES THE FAMILY JOURNEY POLST Strategic Issues PHYSICIAN ORDERS FOR LIFE-SUSTAINING TREATMENT Severe Burns Dialysis The Importance of Knowing Goals of Care The Conversation Project

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