1	Options Associated With Your Care Lisa Conway, LSW Karen Misiura, LCSW
2	Role of The Social Worker Emotional support Access community resources Facilitate communication between patient, family and area agencies. Guidance through trying times
3	Self Determination Act Right to know all benefits and risks of treatment Right to have physician and staff to carry out the patient’s wishes, within the boundaries of the law and the established facility Right to accept/refuse treatment
4	Psychological Implications Difficulty accepting patient’s condition as being terminal or permanently unconscious Conflict if person’s wishes were never made clear Advanced Directive can only be completed when the person is competent No advanced notice of sudden illness
5	Ventilator Patient cannot safely be weaned off ventilator Needs 24-hour care Help with bathing, dressing, changing diaper, turning SNF options limited
6	Tube Feeding SNF for initial care of feeding tube Decision to go home vs. stay at SNF Patient/family instructed on how to care for tube and how to actually give the feedings Home Health Nurses limited Hospice case-by-case basis
7	Hospice Terminal Live with Dignity Live Pain-Free Do Not Resuscitate Maintain the person at home, if possible
8	Hospice Options Home Inpatient Hospice Units Marian Community Hospital Skilled Nursing Facility
9	Home With Support Family agreeable and able to take responsibility to care for the patient Home Health Nurses vs. Private Duty No guarantee of state programs and long wait times until services can begin.