“April 12th has been designated as National Advance Care Planning Day, a day to remind Canadians to think about and talk about their wishes for end-of-life care. Equinoxe LifeCare Solutions is joining a national effort to encourage Canadians to learn more about advance care planning.

“Most of us hope to die peacefully and able to communicate with others until the very end,but death doesn’t usually occur this way,” says Sharon Baxter, Executive Director of the Canadian Hospice Palliative Care Association (CHPCA) and a member of the Advance Care Planning National Task Force. ““Advance care planning helps others make decisions on your behalf when you cannot speak for yourself.”

Advance care planning is a process of reflection and communication about personal care preferences in the event that you become incapable of consenting to or refusing treatment or other care. Your plan may include information about procedures such as CPR and mechanical ventilation, as well as other personal information, such as spiritual preferences or specific wishes for family members or friends.

One of the most important aspects of advance care planning is naming and having a conversation with a Substitute Decision Maker – someone who will speak on your behalf and make decisions for you – but only when you are not able to do so yourself.

According to a 2004 poll conducted by Ipso-Reid on behalf of the Canadian Hospice Palliative Care Association and GlaxoSmithKline, eight in ten respondents agreed that people should start planning for end of life when they are healthy, however 70% of them had not prepared a plan, and 47% had not designated someone to speak for them if they are unable to communicate.

A 2008 study found that the absence of Advance Care Planning, in all its forms, was associated with worse patients’ ratings of quality of life in the terminal phase of the illness and worse ratings of satisfaction by the family during the terminal illness or in the months that follow death.

A new website – www.advancecareplanning.ca – also provides tools and resources to help Canadians start conversations and learn more about making an advance care plan.

“As health care technologies and life saving interventions continue to improve and people live longer – many with complex medical conditions – advance care planning becomes increasingly important,” says Ms. Baxter. “We need to communicate our feelings around the use of certain procedures at the end of life, and what we believe gives our life meaning. These are personal, individual choices that every Canadian deserves at the end of life. Make sure your voice is heard.”

For more information, please visit www.advancecareplanning.ca

You can also contact Equinoxe LifeCare Solutions at 514-935-2600 or info@equinoxe.ca

c/o Speak Up – Canadian Hospice Palliative Care Association

Advance Care Planning Backgrounder

• According to Statistics Canada, each year, more than 248,000 Canadians die, and by 2020, that number will increase to over 330,000.

• In a recent national survey, more than 80% of respondents are concerned the quality of health care in Canada will decline as a result of increased strain on the health care system as our population gets older

• In Canada, seniors 80+ represent the second fastest growing age group – one in five of these seniors will die in hospital, even though a number of them would prefer to die at home or in a palliative care setting.

• In a 2004 poll conducted by Ipso-Reid on behalf of the Canadian Hospice Palliative Care Association and GlaxoSmithKline, 70% of Canadians had not prepared a living will or advance care plan, and 47% of Canadians had not designated a Substitute Decision Maker to make healthcare decisions for them if they a-re unable. Fewer than 44% of respondents had discussed end-of-life care with a family member

• Research indicates that patients who have end-of-life conversations with their doctors and family members are much more likely to be satisfied with their care, will require fewer aggressive interventions at the end of life, place less of a strain on caregivers and are more likely to take advantage of hospice resources or die at home.

• A 2008 study found that the absence of Advance Care Planning, in all its forms, was associated with worse patients’ ratings of quality of life in the terminal phase of the illness and worse ratings of satisfaction by the family during the terminal illness or in the months that follow death.

• A 2010 Canadian study of hospitalized, elderly patients identified that there is a huge unmet need, that providing more support for end-of-life conversations and advance care planning will have a large positive impact on improving end-of-life care in Canada.

References

Ipsos Reid. 10th Annual Report Card on National Health Care. www.cma.ca, last accessed Aug. 28, 2010

Wright, AA, et al. Associations between end-of-life discussion, health care expenditures, JAMA, 2008, 300 (14) 1665-1673

Heyland, DK, Allan DE, Rocker G, Dodek P, Pichoa D, Gafni A. Discussing prognosis with patients and their families near the end of life. Impact on satisfaction with end of life care. Open Medicine 2009, 3(20: 71-80)

Heyland DK, Cook DJ, Rocker GM, Dodek PM, Kutsogiannis DJ, Skrobik Y, Jiang X, Day AG, Cohen SR. Defining priorities for improving end-of-life care in Canada. Can Med Assoc J 2010;182(16):E747- E752. “

Equinoxe Life Care Solutions is hosting a free six week program, My Tool Box, the McGill University Health Centre’s (MUHC) self management course for people living with chronic illness and their loved ones. Through fun, practical exercises participants build strategies for living well with chronic conditions like diabetes, heart disease, cancer, etc. Emphasis is on coping strategies and skills such as establishing realistic, good exercise and nutrition routines, relaxation techniques and communicating effectively with their health care teams.

My Tool Box, the Chronic Disease Self-Management Program (CDSMP) was first developed at Stanford University and is now offered in more than nine languages throughout the world. Trained and certified volunteers who have chronic diseases themselves facilitate the workshops. More than two decades of research shows that CDSMP can make a real difference; participants’ who complete the workshop often feel less fatigue and pain, have fewer emergency room visits and hospital stays. Many people find they have higher energy levels, use better coping strategies, and feel greater confidence when communicating with health care professionals.

The session runs May 2^nd to June 6^th – Mondays from 1:30-4:00 at 4823 Sherbrooke St. West, suite 110.  It will be offered in English only. For more information call Patricia at 514-619-5074

Did you know..:

• Elderly women are more often victims of their children than elderly men?
• Close to 60% of reported abuse cases are financial?
• In Quebec, 80% of fraud cases committed by telephone are of persons aged 60 and over?

The Crime Prevention  Association of Toronto has created a multidimensional quiz that can help highlight some key points and misunderstandings when it comes to fraud.  Take the quiz online or download the PDF to find out if you can identify, prevent and stop fraud if faced with it.

Online quiz: http://abcfraud.ca/

PDF version: http://abcfraud.ca/English_1.pdf

Did you know that close to 1/4 of all nursing home admissions are related to improper self-administration of medications?  Stay at home with Equinoxe’s MedSmart medication dispenser.  MedSmart helps ensure that you get the right medication at the right dose at the right time.  Call 514-935-2600 or email info@equinoxe.ca for more information.

According to the Harvard School of Public Health in Boston, eating more berries can help fend off Parkinson’s disease.  You might want to start adding more fruit to your diet.

  Read more about the study that followed over 130,000 participants for 20 years…

Did you know that 30-50% of clients ignore medication instructions?  This type of non-compliance to medication can be fatal, if not detrimental to a client’s quality of life.  Equinoxe’s MedSmart medication dispenser can increase medication compliance to 100% preventing long term complications and unnecessary hospitalizations.  Call 514-935-2600 for more information.

Planning for end-of-life care is often a difficult subject to broach.  Being prepared and informed on what to expect in end-of-life care is crucial in ensuring that the right decisions are made.  The CMAJ has produced a series of six articles on end-of-life care ranging from advanced directives to national home care standards designed to educate Canadians on how and when to make decisions, not only for those with terminal conditions but also for those who want to plan for the future early.

The articles can be found below:

Part I: Preparing for the inevitable

Part II: Advance directives: obstacles in preparing for the worst (

Part III: End-of-life planning framework calls for fewer checklists, more conversation

Part IV: Tools help patients tackle tough choices for end-of-life care

Part V: National home care standards urged

Part VI: Access to palliative care varies widely across Canada