Use of hospital intensive care units and ventilators Artificial nutrition and hydration (feeding tubes and intravenous fluids) Use of antibiotics Use of preventive health screenings, medications and dietary restrictions E X A M P L E : Colonoscopies and mammograms may not be useful for people who are at the end of life and cannot benefit from or understand these sometimes painful procedures. E X A M P L E : Risks and benefits of medications may change when a person is near the end of life.
A DVA N C E P L A N N I N G
care provide the care team with direction for care planning. Ensure that an interpreter is available to assist with non-native English speakers for these important conversations. what the person would want, taking into consideration expressed preferences, values and past life patterns. When discussing goals, individuals and families need to consider and make decisions about the issues listed below: The steps to take and who to contact when death is near or has occurred. The steps will vary based on the person’s advance directives, if he or she has them.
other diseases a person may have, such as diabetes and congestive heart failure, in relation to the severity of dementia. EX AMPLE:
Hospitalization to treat congestive heart
failure during the end stages of dementia could be hard on the person and may not prolong life. L E G A L A N D O T H E R I M P O R TA N T C O N S I D E R AT I O N S
part of the care plan and translated into medical orders when appropriate. Some states and localities have protocols to implement translation into medical orders such as the Physician’s Orders for Life Sustaining Treatment (POLST). opportunity to rethink their decisions as the person’s needs or condition change.
Cardiopulmonary resuscitation (CPR) Medical procedures and tests (e.g. surgery, blood tests, dialysis) Increasing the level and complexity of care in the home
Medicare and Medicaid payment to document whether patients have advance directives and to provide them with information about their decision-making rights.
Hospitalization Entry into a nursing home Enrollment in hospice
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discussions by providing materials that can assist in making advance planning decisions.