Message from the Colorado Healthcare Ethics Resource Group – Long-Term Care Subcommittee

Call to Action: Colorado Cares for Older Adults – COVID-19 Attention Community Leaders, Situation: COVID-19 has brought specific treatment questions into focus. Even if advance care planning has been completed by your residents in the past, it is time to revisit the conversation to address the current pandemic. We feel that it is important that your organization implement measures to review advance care planning wishes and documents with all of those under your care. We urge you to proactively review advance care planning with your residents, especially those who are over 60 years old and those with co-morbid conditions. This request is also part of the Colorado Crisis Standards of Care approved by Governor Polis. Who is behind this: We are a group of concerned professionals. We are doctors, nurses, social workers, palliative care and hospice staff and family members just like you.  Why: We are living in a complex time filled with uncertainties. In the midst of everything we cannot predict or control, there remain opportunities for collaboration and informed decision-making. What: The attached guides and tip sheets have been designed to help your residents, their families, all of us—consider specific medical treatments, values and decisions in relation to COVID-19.  When:  Start today. In Colorado, the expected ‘surge’ of COVID-19 cases is expected on April 17th.  ACTION REQUESTED: 1.Send to all resident families the email “Family Call to Action email COVID-19”. 2.Send to all Healthcare Professionals the email “Healthcare Professionals COVID-19”. Links include the following: i.   COVID-19 TCP Presentation to learn advance care planning basics. Link to Video ii.   Link to The Conversation Project's Being Prepared in the Time of COVID-19 Guide. iii.   Medical Durable Power of Attorney Document MDPOA (unless already completed, accurate and available). Link to Colorado MDPOA Form iv.   Colorado Website to help with process - (content in English & Spanish/large text option) v.   Link to the COVID-19 Treatment Decision Guide.  If you go to the hospital and become seriously ill, these are the questions you will likely be asked. vi.   Remember to take care of yourself: Link to Remembering the Heart in Turbulent times 3.Develop a plan for who will follow up with staff to have these important conversations. Here is a script (link to script) to help with this conversation.   4.Link to Caregiver Support/Info Resources At the end of the conversation, ensure that decisions and preferences are documented through the proper mechanisms - completing a MOST form, adding a Do Not Hospitalize Order, or a CPR directive and MDPOA. Here are some additional resources around best practice with the MOST form and billing.                10 Things to Know about MOST Video Advance Care Planning Billing Video   This campaign is intended to help you, your staff, your residents and their families to prepare. This is the time to help the people closest to us—our friends, our spouses, our parents or grandparents—get the care that is right for them if they become seriously ill with COVID-19. We are all in this together.  Sincerely, Long-Term Care Leadership on behalf of the Colorado Healthcare Ethics Resource Group – Long-Term Care Subcommittee