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A Health Foundation Project to Support Improved Health Care Decision-Making
The Sharing Your Wishes™ Project
sharingyourwishes.org
Sharing Your Wishes is a program to make older adults aware of the importance of planning in advance for their health care in the event that they experience an illness or condition that prevents them from making or communicating decisions. This is the best way to ensure that their choices are known, understood, and honored.
· Currently, Sharing Your Wishes programs are in 13 counties throughout western and central New York. Each community has a coalition of people committed to improving care for older adults. The effort is supported by the Health Foundation for Western and Central New York, (formerly the Community Health Foundation of Western and Central New York) with the goal of increasing awareness of advance care planning and the importance of health care decision-making for older adults.
· Why community coalitions?
· Where are the coalitions?
· Why health-care decision-making?
· How has Community Health Foundation supported the Sharing Your Wishes coalitions?
· Sharing Your Wishes community education materials
· Americans live longer, healthier lives than ever before. Even with Americans living longer, most will experience serious chronic illness or disability in the last phase of life. It is important that people plan ahead to prepare for complex health issues and dilemmas that may occur in their final years of life.
· Planning ahead for health care helps older adults and their families. Advance care planning not only frees us from worry about how we are going to be treated, it also lifts a burden of responsibility from those we love. By taking action to plan our care in advance, we can give our loved ones peace of mind—not tough choices.
 · Conversation with those who care about you is the most important step. When your loved ones know what is important to you, much can be done to make sure you receive the health care you want. They can also help to ensure your health services are coordinated the way you want them to be. Sharing your wishes for health care is the best way to plan ahead to avoid stress and confusion.
· Your doctor can help you understand the options for care that are available to you. Talking with your doctor will help you and your health care agent to understand the choices for care. Understanding your options helps ensure that you and your health care agent will make choices that will enable you to receive the care you want and to avoid care you do not want.
· The process of planning ahead for health care decisions can be done in four easy steps:
1. Think about what is important to you and how you want to receive your care.
2. Select a person to speak for you if you are unable to speak for yourself.
3. Talk about your health care wishes.
4. Put your choices in writing.
The Sharing Your Wishes Planning Guide will help older adults have conversations with those close to them to plan ahead for health care decisions.
Click here to view Sharing Your Wishes community education materials.
Give Them Peace of Mind, Not Tough Choices
Why Community Coalitions?
It has often been said that health care is a local issue—it is locally provided and locally consumed. That means that, with the exception of changes that can only be implemented through major policy change, improvements in health care begin with people and care systems in local communities. A profound shift in practice can not occur from a centralized location or by a single part of the health care system. It is essential that local partners in our communities work together in this effort. Local—county-based—coalitions on long-term care exist in several places across our regions. Through the support of the Health Foundation these coalitions are able to bring attention to the importance of planning ahead for frailty and the last phase of life.
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Where are the Sharing Your Wishes coalitions?
Allegany County
Community Partnership on Aging
(585) 593-5223
Cattaraugus County
Community Coalition for Advance Care Planning
(716) 373-8032 or (800) 462-2901
Chautauqua County
Chautauqua Cares Coalition
1-888-HCPROXY (1-888-427-7699)
Cayuga County
Human Services Coalition of Cayuga County
(315) 253-9743
Erie County
Coalition for Health Care Decision-Making
(716) 686-8070
Genesee County
Long Term Care Task Force
(585) 343-1611
Niagara County
Niagara Caregivers Network
(716) 285-8224
Orleans County
Long Term Care Task Force
(585) 589-3102
Onondaga County
Sharing Your Wishes Community Coalition
(315) 426-0485 ext. 390
Schuyler County
Office for the Aging
(607) 535-7108
Steuben County
Office for the Aging
(607) 776-7813 Bath
(607) 324-4891 Hornell
(607) 936-4661 Corning
Tompkins County
Health Planning Council of the Human Services Coalition
(607) 273-8686
Wyoming County
Long Term Care Council
(585) 786-6114
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Why health care decision-making?
Essential to the principles of person-centered care is that the person has a major say in what care they receive and what care they choose not to receive. The more disabled an individual becomes, the less able he or she is to make those preferences known when care decisions are being made.
The health care system, with its complex structures, financing options, and multiple points of decision-making, is a daunting one for individuals to navigate. Couple that challenge with the very difficult personal discussions that are necessary to thoughtfully make fully-informed decisions about care preferences, and one can see why such decisions are often put off or made in haste when care is needed. The involvement of a health care agent and the older person’s family is also important so that the person’s desires are supported if the health care agent is called on to speak for the older person.
Effective advance care planning is more than just completing a health proxy form and a living will. For older adults, it is more than thinking about life sustaining treatments. Most older adults will experience several years of gradual decline in the last phase of life. Somewhere along this path, many older adults will need to rely on others to help them make decisions and express their points of view. Conditions such as strokes, hearing loss, and confusion or dementia can make it impossible for older adults to speak for themselves. This may occur years before decisions need to be made about life sustaining treatments and can include a wide range of health decisions.
Advance care planning requires advance consideration of the person’s values and beliefs followed by conversations with families and physicians regarding treatment options, chance of success, and expected quality of life outcomes. The Sharing Your Wishes project has focused on community engagement to encourage older adults and their caregivers to have these important conversations, to plan ahead, and to share their hopes with family and medical care providers. Ultimately, changes are needed in the practice of many health care providers and facilities to ensure that they are sensitive to the wishes of patients both in guiding care decisions and in the implementation of systems that allow easy access to documentation of preferences.
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How has the Health Foundation supported the Sharing Your Wishes coalitions?
The Foundation has facilitated a learning community between the six community coalitions. Representatives of the six coalitions attend periodic workshops and coordinators meetings. They have learned about model practices to support advance care planning with community education, changes to community practice, and systems change. They have received coaching on presentation skills with guidelines to support sharing the message. They have participated in discussions about working with persons with dementia, communicating with difficult families, overcoming pre-existing ideas to strengthen community practice, measuring impact, and developing system changes. Each coalition has also received a two-year grant to support part-time project coordination and related project activities.
In addition, the Health Foundation developed community education materials and a DVD with video clips and scenarios to support community understanding of advance care planning.
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For Sharing Your Wishes community education materials, click on the items below. To get more materials and information, including posters and a DVD with scenarios and video clips, visit sharingyourwishes.org.
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