Quiz: How Much Do You Know About Advance Care Planning?

1. Advance Care Planning is:

2. Advance Care Planning is NOT consent for a treatment.

True or False?

3. Public Guardian and Trustee can become the Substitute Decision Maker if two or more SDMs that are equal ranking cannot agree on a decision for a person.

4. Which of the following best describes Advance Care Planning?

5. Mr. Lewis, 78, was admitted to the hospital with an infection and delirium. Unlike his normal behaviour, he became very confused and didn’t know where he was. His son, Jeremy (52) who is his POA for Personal Care, was called to help make decisions about his treatment.

2 days later, Mr. Lewis’ delirium has resolved. He is now alert, and oriented to when/where he is. Though he’s no longer delirious, he is still in the hospital being treated for the infection. Unfortunately, he will require a PICC line for ongoing IV antibiotics.

What is the most appropriate next step?

6.

A 42-year-old woman is brought to hospital and is found to be incapable of making treatment decisions. She does not have a Power of Attorney for Personal Care.

• She has been separated from her ex husband for 2 years but the divorce is not final. He lives in across town
• She currently lives with her 16 year old son
• Both of her parents are deceased
• Her older brother lives in a different province

Who is her substitute decision-maker?

7. Mary (75), who has been diagnosed with dementia, lives in a care facility.  It is time for annual flu shots but Mary adamantly refuses, expressing that she never used to get them prior to coming to the care facility. Her daughter, Sarah (47) is Power of Attorney for personal care and tells the staff  they should give her mother the vaccine anyway because she doesn’t want her mother to catch the flu. Because Mary has dementia, the staff at the care facility must listen to her Power of Attorney for Personal Care.

8. A health care provider can involve the Public Guardian and Trustee if they believe a substitute decision-maker is not acting in the patient’s best interests.

9.

Ella, 15, has been undergoing chemotherapy for leukemia off and on for 8 years. During a visit to the cancer centre, she tells the oncologist that she wants to stop chemo. She says she knows this could mean she might die sooner, but the chemo just makes her so sick she isn’t able to enjoy anything.

Her parents strongly disagree and insist that treatment continue.

What is the most appropriate next step?

10. Morris (88) has 2 biological children, Luis (57) and Valerie (60). He also has 1 step-daughter, Francis (55), who he has raised since she was 5 years old. Morris has late stage dementia and lives in long-term care. He does not have a spouse or partner and has not appointed a Power of Attorney for Personal Care. The doctors want to know if it’s ok to give Morris some treatments for a wound after he suffered a fall. Luis and Valerie say this treatment is ok, but Francis suggests a different treatment. The doctor cannot give Morris the treatment because Luis, Valerie and Francis are not all in agreement.