OSF Healthcare has developed a Supportive Care Governance Council, comprised of leaders and physicians, to improve the care we deliver to patients with chronic progressive diseases. Supportive Care is an approach and highly structured system of coordinated services across the system, meeting the individualized needs of the patient and their loved ones. The OSF Supportive Care Model promises patients that:

• You will never be overwhelmed by symptoms.
• Your care will be continuous, comprehensive and coordinated.
• You will be provided with whatever information necessary to help you understand your condition and have the opportunity to discuss your condition with your family members and care providers.
• Your decisions are important and will be sought out, respected and whenever possible, followed.

One component of Supportive Care is palliative care, which focuses on relieving the pain, symptoms and stress of serious illness. Recently, six OSF hospitals each developed and then presented their palliative care programs for inpatients to the Supportive Care Governance Council, which were all approved. (Note: OSF Holy Family Medical Center will develop their service this fiscal year.

We also have Supportive Care collaborative teams which are designing a standardized comprehensive advance care planning process that crosses the continuum of care. Leaders from all OSF geographic regions recently attended a three-day seminar called Respecting Choices, to learn how to develop and implement advance care planning.

We are placing importance on not only the documentation of a patient’s wishes, but also on the discussion of these wishes between a patient and their care team and family. Studies have shown that although people believe their families know their wishes for their care, but this is often not the case.

Advance care planning is a way for you to discuss the kind of care you want and do not want at the end of your life. You can also express your wishes about the care you wish to receive should you become unable to make those decisions or speak for yourself.

It can be best defined as a process for providing patients and/or their family’s information about the normal course of their disease over time, initiating and encouraging discussions related to future medical care, choice of surrogate decision-maker, treatment and choices across the continuum of care. You should be provided education and information to assure you have sufficient knowledge and understanding to make informed care choices. The goal of advance care planning is to address these issues before a crisis occurs. By having an advance care plan in place, the patient’s and family’s wishes are clear and the healthcare system can honor them.

An advance directive is a form that details what kind of care you want if you become unable to make your own medical decisions. This form gives direction to your physician and family members. Each state has different laws about advance directives; please ask your physician about the laws in your state. By completing an advance directive, you are able to detail any treatments you do or do not want. For example, if you had a life-limiting illness and decided that if your heart were to stop you did not want to you’re your chest compressed in an attempt to start you heart again you would ask you could state you did not want cardio pulmonary resuscitation (CPR) on your advance directive.

An advance directive also allows you to name someone – a spouse, family member or friend – to make medical decisions for you if you are unable to communicate for yourself. This is called a durable power of attorney for healthcare.

Another kind of advance directive is a living will. A living will is only effective if you have a life-limiting/terminal illness. You can state what kind of medical treatment you prefer or do not wish to have in your living will. You should be aware that the living will does not give you the option of authorizing anyone else to make medical decisions on your behalf. The Advance Directive/Durable Power of Attorney for Healthcare is the document that allows you to appoint someone to speak on your behalf should you be unable to do so.

If you do not already have advance care planning in place, now is the best time to begin. It is difficult to think about what type of care you want in difficult situations, especially when you are healthy now, but accidents and serious illness can occur at any time.

It is best to document your desires while you are thinking clearly and are able to discuss your treatment options and decisions with your physician and family members. It is your right to determine your future care. Advance directives can also be revisited and revised at any time. Studies show that patients who have advance care planning have less anxiety and fear and are comforted knowing their physician has an understanding of their wishes.

How do you begin Advance Care Planning?
To create an advance directive, you will need to do one of the following steps:

• Obtain a form online by visiting:

http://www.caringinfo.org/userfiles/File/Illinois.pdf
http://www.caringinfo.org/UserFiles/File/Michigan.pdf

The most important thing you can do when you are creating your advance directive is to talk to your loved ones and your physician. Give your physician and the person you appoint as your agent a copy of your advance directive. When you select an agent make sure you select someone who is nearby, who understands your desires and can make decisions in stressful situations following your wishes. Always talk to your agent about your wishes for medical care should you no longer be able to make these decisions yourself. I encourage individuals to make sure they share these views with all their loved ones. We never know what the future will bring and it can be such a comfort to family members when they know the wishes of their loved one and recognize the appointed agent is carrying out these wishes to the best of their ability.

As a result of National Healthcare Decisions Day, I hope that more people in our community can have thoughtful conversations about their healthcare decisions and complete advance directives to make their wishes known.

Fewer families and healthcare providers will have to struggle with making difficult healthcare decisions in the absence of guidance from the patient, and healthcare providers and facilities will be better equipped to address advance healthcare planning issues before a crisis and be better able to honor patient wishes when the time comes to do so.

Katie Jones
President and Chief Executive Officer, OSF Home Care Services
Chairperson, OSF Supportive Care Governance Council