What is advanced care planning?
- It may include an advanced dirrective
- it may include a representation agreement
Advanced Care Planning allows individuals to express their treatment wishes regardless of their age.
What is an advanced directive document?
- Medical order - informs care
- Written instructions to healthcare providers regarding treatment wishes
- Does not need to be completed in consultation with a qualified health professional
- Requires a witness/notarization
What is an repersentation agreement document?
- Legally binding document
- Appoints temporary decision maker if incapacitated
You must be 19 years of age or older to make a representation agreement
The key difference between the RA7 and the RA9 is the capability requirements of each
List the Temporary Substitute Decision Makers (TSDM) in order of priority.
- Spouse
- Son or daughter (19 or older)
- Parent
- Brother or sister
- Grandparent
- Grandchild
- Anyone related by birth or adoption
- Close friend
- Person immediately related by
These individuals are designated to make healthcare decisions if the patient is unable to do so.
If the adult is:
capable:
incapable:
in an emergency situation:
capable: obtain consent from the adult
incapable: obtain consent from the SDM, if available
in an emergency situation, if the adult is incapable and SDM is not able to provide direction, the last valid MOST is followed
What is the Medical Orders for Scope of Treatment (MOST) document and what does it provide?
A medical order written by a doctor or nurse practitioner.
Based on a discussion with the patient about their wishes.
Lays out the patient’s medical wishes
* Orders for CPR
* Medical treatment focused on comfort care
* Aggressive treatments (Intensive Care)
What should practitioners consider regarding an Advanced Care Plan (ACP) or MOST?
- Check if the patient has an ACP or MOST in record
- Ask the adult/SDM if they have ACP documents or a MOST
- Discuss ACP and goals of care with the adult or SDM
- Document results of conversations and any new actions
These considerations ensure that patient preferences are respected and documented.
What is the key difference between RA7 and RA9
Financial and Legal Matters:
Capacity Requirements:
Health and Personal Care:
Purpose:
RA7:
Financial and Legal Matters: Can include authority for the routine management of financial and legal affairs.
Capacity Requirements: Can be made by an adult who may have diminished capacity and requires assistance with decisions.
Health and Personal Care: Includes authority for minor and major health and personal care decisions.
Purpose: Provides a way to handle routine financial matters for someone who may not be able to create an Enduring Power of Attorney.
RA9:
Financial and Legal Matters: Does not include financial or legal affairs.
Capacity Requirements: Can only be made by an adult who has full capacity and understands the consequences of the agreement.
Health and Personal Care: Includes the most comprehensive health and personal care authority, including the ability to make major health decisions, and can include specific authority over things like the care of the adult’s minor children if stated.
Purpose: Provides the broadest possible powers for health and personal care decisions for a capable adult.
What does the Adult Guardianship Act (AGA) protect?
- Vulnerable adults with illness, disease, injury, or condition that makes them vulnerable to abuse, neglect, and/or self-neglect.
- Individuals at risk of abuse, neglect, or self-neglect
investigate situations in which vulnerable adults may be living at risk and tools to intervene
List the guiding principles of the Adult Guardianship Act.
- Protects vulnerable adults in BC
- Investigate abuse, neglect, and self-neglect
- Least restrictive form of support
- Guardianship as a last resort
These principles ensure that vulnerable adults receive appropriate care and protection.
Why RA7 over guardianship?
- Adults lose their civil rights and become a non-person
- The RA7 is intended to enable ALL adults to maintain their PERSONHOOD. Even if an adult does not meet the traditional definition of capability, they may make an RA7. This ensures access to support as needed. It is about equality.
