Honoring Resident Choice

1. Honoring Resident Choice • Putting the Pieces Together • End of Life Care

2. Objectives • Discuss honoring choice, at end of Life • Discuss advanced care planning • Recognize change in condition in active decline • Recognize the importance of empowering staff • Identify Complementary Therapies

3. Life’s Journey

4. Resident Centered • Honors Resident Choice • Supports Family • Provides Education Resident Directed Care means Residents have a Right to Refuse any Aspect of Care

5. Resident Centered

6. Communicate • Thoughts about what they want at end of life • Are prepared to have the conversation • Allow the conversation The Resident regains a Sense of Control

7. Resident Centered Communicate Candid

8. Commit • Structured process for advance care planning. • Keep Resident and families informed about medical conditions and interventions after they enter the palliative phase of life. • Policies and Procedures

9. Commit Resident Centered Care Communicate Candid

10. Candid • Resident is able to communicate their wishes • Relief from residents and family members • Advanced Care Planning ensures residents and family members understands their decisions.

11. Commit Resident Centered Complementary Care Change in Condition Candid Communicate Candid

12. Consideration • Desire to Die in their Home • Reasons for Hospital Transfers • Lack of Confidence • Fear of Legal Liability • Fear of Family Pressure

13. Commit Consideration Resident Centered Change in Condition Candid Communicate Candid

14. Consequence • Alone and Frightened • Long Wait • Traumatic • Confused • Unfamiliar faces The Care may still Not Sustain Life

15. Commit Consideration Consequence Resident Centered Care Candid Communicate Candid

16. Change in Condition

17. Commit Consideration Consequence Resident Centered Change in Condition Candid Communicate

18. Care Good end-of-life care means: • Providing person-directed care • Pay close attention to the individual resident • Know the resident’s values, goals, and preferences • Honor the resident’s wishes

19. Commit Consideration Consequence Resident Centered Care Change in Condition Candid Communicate Candid

20. Caregiver • Empower Caregivers • Be Available • Share Memories • Be Present • Provide a Gentle Touch • Speak Gently

21. Commit Caregiver Consideration Consequence Resident Centered Care Change in Condition Candid Communicate Candid

22. Compassion • Honor with Residents wishes • Family feels in Control • Resident are not Fearful • Established Trust • Will not be in Pain • Have an Emotional Connection with Staff

23. Commit Caregiver Consideration Consequence Compassion Resident Centered Care Change in Condition Candid Communicate Candid

24. Complementary • Soft Music • Aromatherapy • Flameless Candles • Healing Touch • Religious Material • Pet Therapy

25. Commit Caregiver Consideration Consequence Compassion Resident Centered Complementary Care Change in Condition Candid Communicate Candid

26. Coach • Focus on the dying person • Share memories • Be present and patient • Provide reassurance • Speak gently

27. Commit Caregiver Consideration Consequence Compassion Coach Resident Centered Complementary Care Change in Condition Candid Communicate Candid

28. Circle Circle of Remembrance • Tribute in Memory of a Resident • Acknowledge our own Sadness • Share Memories • Honors the Work we have Done • Honors the Life of the Resident

29. Commit Caregiver Consideration Consequence Circle Compassion Coach Resident Centered Complementary Care Change in Condition Candid Communicate Candid

30. Challenge

31. Commit Caregiver Consideration Consequence Circle Compassion Coach Resident Centered Complementary Care Change in Condition Candid Communicate Candid

33. References The Lion King - Circle of Life (Clip) http://www.youtube.com/watch?v=HwSKkKrUzUk Interact - Advance Care Planning Tools • Advance Care Planning Tracking Tool   • Advance Care Planning Communication Guide   • Identifying Residents Who May be Appropriate for Hospice or Palliative/Comfort Care Orders   • Comfort Care Order Set   Deciding About Going to the Hospital   • Education on CPR Education on Tube Feeding http://www.interact2.net/tools_v3.aspx Book • Gone From My Sight -The Dying Experience by Barbara Karnes https://bkbooks.com/shop/gone-my-sight