talking about death: living life to the fullest lucia d. wocial, phd, rn woltman inter-professional...
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Talking about death: Living life to the
fullest
Talking about death: Living life to the
fullest
Lucia D. Wocial, PhD, RNWoltman Inter-professional Communication
Scholars ProgramIU School of Nursing
ObjectivesObjectives
Identify barriers to having conversations about end-of-life planning.Demonstrate essential skills for initiating and participating in discussions about of end-of-life planning.Identify resources for clients to assist them in having these conversations with the important people in their lives.Discuss why having these conversations matters.
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<50 % of the severely or terminally ill patients have an AD in the medical record.Only 12 % of patients received input from their physician in its development.
Low rates of ADLow rates of AD
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Between 65 and 76 % of physicians whose patients had an advance directive were not aware that it existed.Until fairly recently, conversations about end of life planning was not part of training for physicians.
Inadequate trainingInadequate training
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General public predicts 54% survival to discharge for in-hospital CPROverall, survival for victims of cardiac arrest to hospital discharge has been estimated between 0% and 10%.
Marco & Larkin, 2008
Enamored with technologyEnamored with technology
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Talk about what people need to know, not just what they want to
hear
Talk about what people need to know, not just what they want to
hear
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The Four Things That Matter Most
The Four Things That Matter Most
Please forgive me. I forgive you. Thank you. I love you.
The Four Things That Matter MostA Book About Livingby Ira Byock, M. D.
04/19/23 13
• identify values • choose surrogates wisely • decide whether to grant flexibility• inform others of your wishes
McMahan, Knight, Fried, and Sudore, 2013
Beyond Advance DirectivesBeyond Advance Directives
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Patients who had advance planning discussions with their physicians continued to discuss and talk about these concerns with their families.Such discussions enabled patients and families to reconcile their differences about end-of-life care.
AHRQ Report
Patients value discussionsPatients value discussions
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You have a good chance at recovery.• 30%• Six months in a skilled nursing facility• Will not return to independent living
What would you want?What would you want?
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The QuestionThe Question
“Have you and your loved ones ever talked about what you would want if things don’t go the way you hope?”
LLearn about your options, choices and decisions
IImplement your advance directive plans
VVoice your end-of-life wishes
EEngage others to talk about their wishes
It is about LIVINGIt is about LIVING
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The Other ObjectiveThe Other Objective
Change the way you talk to your clients.Make time for these conversations, personally and professionally.Enthusiastically assist clients when they want to discuss advance care planning.
MotivationMotivation
2.5 million people die each year.80% who die in hospitals have no decision making capacity.>30 % of these patients are on life support.Decision making falls to surrogates, usually family members.
If people think you care they will trust youThis is the most caring conversation you will haveIt cannot be the last slide in your presentation
Reframing your challengeReframing your challenge
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