Home--The Chicago Region Advance Care Planning Coalition


Home Who We Are Advance Care Planning Project Structure Inaugural Event Seminar/Workshop Overview Work Plan Resources Media Contact	Advance Care Planning How and where people die in the U.S. has changed dramatically over the past 30 years. Currently, an estimated 80 percent of Americans will die in institutions and 50 percent of these will be incapable of making their own decisions. Widespread media attention over cases such as Terri Schiavo, Nancy Cruzan, and Karen Ann Quinlan has underscored the need for communication regarding patient and family wishes and encouraged many adults to create advance directives – that is, to document their preferences for future medical care, including end-of-life preferences. Unfortunately, even the completion of a document does not always guarantee that patients will receive the care they and/or their families desire. The September 2005 report from The President’s Council on Bioethics, Taking Care: Ethical Caregiving in Our Aging Society, came to the following conclusion: “The need to make decisions on behalf of others will only become more complicated as the American population ages; and it is misleading to think that, through wider use of living wills, competent persons will be able to direct their own care simply by leaving detailed instructions in advance.” An Advance Directive is, in essence, an instruction or set of instructions that dictates the type of medical care one should or should not receive if one were to become incapacitated or non communicative. Some examples of Advance Directives are: Living Wills, Healthcare Powers of Attorney, and documents such as “Five Wishes.” In response to poor outcomes on the effectiveness of advance directives alone as a tool for communication, attention has turned to another method of making future medical wishes known. This new method, referred to as Advance Care Planning (ACP), focuses on ongoing communication and the process of planning for future medical care instead of fixating on a single, one-time event such as signing a document. While ACP can include advance directive documents, it is also an ongoing, living conversation and decision-making process between patients, families, designated agents and medical practitioners where end-of-life medical wishes are discussed. If initiated while the individual is capable, these conversations provide needed information and give the individual time necessary to understand and interpret the information in the context of her or his own values and goals. ACP also involves the designated agent or power of attorney for healthcare in these conversations giving the agent the necessary insight to make informed decisions on behalf of the individual they represent. The Someone to Trust Service Model and Outcomes Task Force has chosen the highly regarded Respecting Choices® program that was developed in La Crosse, WI, as an advance care planning model. Respecting Choices® provides education and consultation services in the following areas: Community Engagement ACP Facilitation & Skill Development Systems to Honor People’s Choices Continuous Quality Improvement This model has been replicated in over 40 communities in the U.S. and Canada and throughout Australia. However, the Someone to Trust initiative is the first attempt to adapt the Respecting Choices® program to a city of the size and complexity of Chicago. For more information on the Respecting Choices® model, click here.
For more information on the Someone to Trust Advance Care Planning Initiative, contact Karen Long, MA, Program Director at 312-636-9261 or someonetotrust@iomc.org.