Just revisiting an old post after listening to a great podcast – ‘The Good GP‘. It got me thinking. We know that General Practice is a good thing and reduces hospitalization rates (and hence healthcare costs) – but how can we measure this in our own practices?

 

 

Professor Barbara Starfield’s work clearly demonstrates that countries with a strong GP-centred system have much better health outcomes than countries that don’t.

 

 

Maybe utilization of Advance Care Directives could be part of this?

 

 

Read on!

 

 

We have all wished for superpowers – I know I have! Flying, changing the past, and predicting the future would all be fantastic abilities to have. I can’t promise the ability to fly, nor can I give you last weeks winning Lotto numbers prior to last weeks draw. However, I can predict the future for you. At some point in the future, all of us will be unable to make decisions for ourselves. We may be unlucky enough to be in an accident, have a severe illness, or we may just be facing the final stages of a long life well lived, but the time will come. I was lucky enough to hear Dr Chris Moy speak eloquently on some changes to the law here in South Australia that will give all of us the power to have decisions made for us, according to our wishes, if we cannot express them at the time.

 

 

Why is this important?

 

 

This is why.

 

 

 

 

From SA Health:

 

From 1 July there will be a clear decision-making framework and new protections for health practitioners when they find themselves in the difficult position of trying to determine what someone in their care might want, at a time when their patient’s ability to make decisions is impaired.

 

 

The new Advance Care Directive Form replaces the existing Medical Power of Attorney, Anticipatory Direction and Enduring Power of Guardianship with a single Advance Care Directive Form (however any of these existing forms will continue to have legal effect post 1 July 2014).

The Advance Care Directive Form allows individuals to appoint substitute decision-makers and/or to clearly document their values, wishes and instructions with respect to their future health care, living arrangements and other personal matters.

 

 

 

 

You can find the form here:

 

 

And you can find some further information here:

Or you can complete it online here:

 

Use your new power wisely!

 

 

Remember, if you have any questions, ask Your GP!

 

 

 

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

 

 

 

UPDATE:

From David Coluccio of Senexus Aged Care Solutions!

Hi there,
http://www.linkedin.com/pulse/two-small-pieces-paper-guaranteed-save-your-family-time-coluccio 
Kind regards, David

UPDATE 2:

What are the costs of aged care?

Read here and any questions? Partridge Street General Practice are Here.

UPDATE 3:

Some further reading on end of life care!

 

• Five Wishes
• POLST (Physician Orders for Life Sustaining Care)

 

 

And there’s more…

 

 

Most nursing home residents want CPR if their heart stops in the belief they’ll have a good outcome, a national survey reveals.

While survival rates after cardiac arrest are as low as 5% for older people receiving CPR, a survey of more than 2000 nursing home residents found 44% believed they had a good chance of recovering.

“This view is perhaps not surprising given that opinions about the likely outcomes from CPR are often informed by television medical dramas,” said researchers from Monash University.

The misplaced perceptions likely explained why 53% of residents expressed a desire to receive CPR in the event of cardiac arrest, they added.

“These findings highlight the need for older people to be better informed about cardiopulmonary resuscitation, including a clear understanding of what is involved … and a realistic perception of outcomes,” they suggested.

The researchers said the wide gap between expectations and reality also showed the need for novel approaches to end-of life planning in nursing homes.

A new ‘Goals of Care’ model had been developed to replace the old ‘Not For Resuscitation’ orders, they noted.

Under this system, the doctor could assign a patient to curative, palliative or terminal phases of care, based on an assessment of their likely treatment outcomes.

“This transfers the technical medical decision-making responsibility to a physician, who can work with the preferences of the patient or resident, but has an understanding of how likely it is for victim to achieve their previous health state,” the authors explained.