How will ACP and my wishes help my SDM in a future goals of care conversation?
- Healthcare providers will provide information on your current condition and discuss treatment options with your SDM.
- Your SDM's role is to determine the option that is best for you. They will think about your wishes and values and tell the healthcare team this as part of a goals of care conversation.
- Since you will be incapable of participating at the time, it is important to share information on your values, and what is important to you during the ACP process.
How will my values be used to make my healthcare decisions?
- Making healthcare decisions is about more than just the medical facts.
- A person's values and goals are an important part of the process.
- If you are capable of making your own decisions, you bring your values and goals to the conversation.
- But once you have lost capacity, it will be your SDM's role to share them with your healthcare providers.
Your SDM's role:
- Think about your values, goals and beliefs
- How do they apply to the decision?
- Decide if the risk are acceptable
Healthcare team role:
- Explain the medical facts about your condition
- Explain all treatment options
- Explain all side effects and benefits of the treatment options
Some helpful hints for how to share your wishes:
- Instead of saying " I don't want a feeding tube" you might tell them "If I am unable to recognize anyone or communicate with people and am dependent for all care, I would not want treatments that would prolong my life"
- Saying "no heroics" is often not enough guidance for your SDM in the future. Help them understand what you mean when you say this.
How are best interests decided?
- It will be your SDM's role to decide on your best interests at the time a decision is being made.
- They will base this on what they know about you as person and any ACP conversations you may have had.
- Best interests are used for decision making when here are no prior capable wishes that apply to the situation. Or those wishes are impossible to follow.
- An example of an impossible wish might be wanting to get all your care at home. There may come a time when this is not possible for financial reasons or because your family are physically unable to provide the care.
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