Monthly Newsletter
June 2019
Featured Event
4 th Annual Clinical Ethics “Boot Camp”
What happens when a person does not have an Advance Directive (AD) and becomes critically ill or injured? What happens when a critically ill person has an AD, but it is not clear? What happens if the Patient Advocate agreed to serve in the role, but never had a meaningful conversation with the person about what matters most?

Healthcare teams and families across the U.S. face these dilemmas every day. Sometimes, the family consults with the physicians, nurses, social workers and chaplains and is able to come up with some type of plan. Other times, there is no clear direction, and an “Ethics Consult” is requested. In May, Munson Health had their 4 th Annual Clinical Ethics “Boot Camp”, a time for healthcare professionals to come together and discuss the challenges of patient cases with no “clear” answer.

Our thanks to Stephanie VanSlyke and her planning committee at Munson Health for including MCM in the Patient Autonomy portion of the presentations. The caliber of the other speakers was outstanding, and the scenarios thought-provoking. You can access the presentation information here:

Upcoming Events
First Steps Advance Care Planning
Facilitator Training

Friday, August 9, 2019

Stay Tuned for More Information

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Did You Know?
Right now, 1 in 3 seniors dies with Alzheimer’s or another dementia, killing more people than breast cancer or prostate cancer combined.

June is Alzheimer’s and Brain Health Awareness Month. Given that more people are living to much older ages due to improved chronic disease management, the amount of people living with dementia is set to triple in the next 30 years (Alzheimer’s Assn., 2018). As dementia progresses, a person’s capacity to make healthcare-related decisions declines. This is not the same as competency , which is the exercise of basic rights under the law, managing one’s own affairs, providing for one’s basic needs, and making decisions in general.

To make a healthcare-related decision, a person must be able to UNDERSTAND (take in information), DELIBERATE ( process information taken in), and COMMUNICATE (articulate conclusion/choice based on understanding and deliberating) (R. Johnson MD, 2018). There is a growing effort to have people approaching their senior years complete advance directives (AD) which include the possibility of dementia. Making Choices Michigan does have access to dementia AD treatment preference forms.

But what about people who have already begun traveling down the long dementia road? Is it too late for them to tell us what they would want as their brain disease progresses? For example, in later stages of dementia it is not uncommon to have difficulty swallowing, thus aspirating (inhaling) fluid and food into their lungs, leading to pneumonia. Would the person want antibiotics to treat the pneumonia, and/or a tube feeding in an attempt to avoid aspiration? Or, would the person choose to continue eating/drinking and take their chances on either improving without treatment or let the disease run its course and perhaps die from the pneumonia? Would the person want to go to the hospital for every serious course of illness, or instead stay in their own living environment, perhaps with hospice?

Recently one of my family members was in the mid stage of Alzheimer’s. Although she couldn’t remember what she ate for breakfast or lunch, so could (repeatedly) tell me the story of a relative who kept trying to force feed his mother, who was in the later stage of dementia. His mother would continuously fight the spoon in her mouth and spit out whatever food entered. She told her son, “I have to die from something!” For my family member, I simply switched the situation and asked, “If that would happen to you, do you want me to force feed you or just let you eat as you wish?” Her answer was plain and simple: “If I want it, I’ll eat it. If I don’t leave me alone.” That statement showed an understanding of the situation, deliberation of the information, and a clear voicing of her choice for force feeding. We immediately added that to her advance directive treatment preferences section.

If you have questions about dementia, and/or advance care planning, we are here to help! You can also contact our local Alzheimer’s Association, Area on Aging of West Michigan, or Rethinking Dementia. Most importantly, if you don’t have an Advance Directive, decide while you still can! Make an appointment with us today.

Our Impact
Thanks to our partners around the state who register their patient and client Advance Directives to Great Lakes Health Connect, we now have over 60,000 documents available in the Community Health Record! Registering these documents makes them available (only as appropriate) to a state-wide network of hospitals, primary, specialty, and allied care organizations, ensuring that healthcare providers will have immediate access to their patient's wishes.
Click here to learn more about registering your patient and client documents or to schedule your ACP appointment today!
Making Choices Michigan | Office: (616) 421-4840 |