{"product_id":"my-advance-care-plan-digital-english-he3322","title":"My advance care plan (digital) - English - HE3322","description":"\u003ch3\u003etō tātou reo | advance care planning\u003c\/h3\u003e\n\u003cp\u003eTe whakamahere tiaki i mua te wātaumaha\u003cbr\u003ePlan the health care you want in the future\u003cbr\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cblockquote\u003eE hono ana tātau ki te whenua mai i te matihe ote ora tuatahi tae noa ki te whakamutunga. E kawea ana te wairua i roto i te puku o te hau ki te okiokinga o ngā tīpuna.\u003c\/blockquote\u003e\n\u003cblockquote\u003e\n\u003cbr\u003eWe are connected to the land from the frst breath of life to the last. Our spirit is carried within the belly of the wind to the resting place of the ancestors.\u003cbr\u003e\n\u003c\/blockquote\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003eLen Hetet (Ngāti Tūwharetoa, Ngāti Maniapoto, Te Ātiawa, Ngāti Apa)\u003cbr\u003e\u003c\/p\u003e\n\u003ch3\u003eMy advance care plan\u003c\/h3\u003e\n\u003cp\u003eThis is my advance care plan and contains my decisions about my health care and treatment. Please follow this plan if I am unable to tell you what I want. \u003cbr\u003eFor more information about advance care planning go to \u003ca href=\"https:\/\/www.myacp.org.nz\/\"\u003eAdvance care planning\u003c\/a\u003e\u003cbr\u003e\u003c\/p\u003e\n\u003ch3\u003eWhat matters to me \u003c\/h3\u003e\n\u003cp\u003eThis is what I want my whānau, loved ones and health care team to know about who I am and what matters to me.\u003cbr\u003eMy cultural, religious and spiritual values, rituals and beliefs:\u003cbr\u003eTo honour these beliefs, I want my whānau, loved ones and health care team to:\u003cbr\u003e\u003c\/p\u003e\n\u003ch3\u003eWhat worries me\u003c\/h3\u003e\n\u003cp\u003eThis is what I want my whānau, loved ones and health care team to know about what worries me.\u003cbr\u003eI worry about:\u003cbr\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003emy loved ones because:\u003c\/li\u003e\n\u003cli\u003esuffering. To me this means:\u003c\/li\u003e\n\u003cli\u003enot being able to talk or communicate\u003c\/li\u003e\n\u003cli\u003enot doing things such as:\u003c\/li\u003e\n\u003cli\u003eother things that worry me are:\u003c\/li\u003e\n\u003cli\u003enothing worries me\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch3\u003eWhy I’m making an advance care plan\u003c\/h3\u003e\n\u003cul\u003e\n\u003cli\u003eThis is why I am making my advance care plan:\u003c\/li\u003e\n\u003cli\u003eI am well.\u003c\/li\u003e\n\u003cli\u003eI am receiving care and treatment for the following:\u003c\/li\u003e\n\u003cli\u003eI understand this may happen to my health in the future:\u003c\/li\u003e\n\u003cli\u003eFacing my future makes me think about:\u003c\/li\u003e\n\u003cli\u003eFacing my future makes me feel: \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch3\u003eMaking decisions and sharing information about my health\u003c\/h3\u003e\n\u003cp\u003eThese scales might help you think about how you like to make decisions and how you prefer your medical information to be shared. Mark along the scale what you would want.\u003cbr\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003eI like to know:\n\u003cul\u003e\n\u003cli\u003eonly the basics\u003c\/li\u003e\n\u003cli\u003eall the details about my condition and my treatment \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003eAs doctors treat me, I would like: \n\u003cul\u003e\n\u003cli\u003emy doctors to do what they think best\u003c\/li\u003e\n\u003cli\u003eto have a say in every decision \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003eIf I had an illness that was going to shorten my life, I prefer to:\n\u003cul\u003e\n\u003cli\u003eknow my doctor’s best estimate for how  long I have to live\u003c\/li\u003e\n\u003cli\u003enot know how quickly it is likely to progress \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003eHow involved do you want your loved ones to be?\n\u003cul\u003e\n\u003cli\u003eI want them to do exactly as I have said, even if it makes them uncomfortable\u003c\/li\u003e\n\u003cli\u003eI want them to do what brings them peace, even if it goes it against what I have said \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003eWhen it comes to sharing information:\n\u003cul\u003e\n\u003cli\u003eI don’t want my loved ones to know anything about my health\u003c\/li\u003e\n\u003cli\u003eI am comfortable with my loved ones knowing everything about my health \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch3\u003eIf I am unable to make decisions, I would prefer them to be made like this\u003c\/h3\u003e\n\u003cp style=\"padding-left: 40px;\"\u003eI want the following enduring power of attorney for personal care and welfare to make decisions using the information in this advance care plan.\u003cbr\u003e\u003c\/p\u003e\n\u003cp style=\"padding-left: 40px;\"\u003eName:\u003cbr\u003e\u003c\/p\u003e\n\u003cp style=\"padding-left: 40px;\"\u003eRelationship to me:\u003cbr\u003e\u003c\/p\u003e\n\u003cp style=\"padding-left: 40px;\"\u003ePhone:\u003cbr\u003eOR\u003cbr\u003eI don’t have an enduring power of attorney. Using the information in this advance care plan, the following person will help my health care team make the best decisions for me.\u003cbr\u003e\u003c\/p\u003e\n\u003cp style=\"padding-left: 40px;\"\u003eName:\u003cbr\u003e\u003c\/p\u003e\n\u003cp style=\"padding-left: 40px;\"\u003eRelationship to me:\u003cbr\u003e\u003c\/p\u003e\n\u003cp style=\"padding-left: 40px;\"\u003ePhone:\u003cbr\u003eIn addition, the following people know me well and understand what is important to me. I would like them included in discussions about my care and treatment.\u003cbr\u003eName:\u003cbr\u003eRelationship to me:\u003cbr\u003e\u003c\/p\u003e\n\u003ch3\u003eWhen I am dying\u003c\/h3\u003e\n\u003cp\u003eAs I am dying, my quality of life means:\u003cbr\u003eOther details I would like you to know:\u003cbr\u003eI understand that when I am dying my comfort and dignity will always be looked after. This will include food and drink if I am able to have them.\u003cbr\u003eIn addition, I would like you to:\u003cbr\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli style=\"list-style-type: none;\"\u003e\n\u003cul\u003e\n\u003cli\u003elet the people who are important to me be with me\u003c\/li\u003e\n\u003cli\u003etake out things like tubes that don’t add to my comfort\u003c\/li\u003e\n\u003cli\u003estop medicines and treatments that don’t add to my comfort\u003c\/li\u003e\n\u003cli\u003eattend to my cultural, religious and spiritual needs, as I described in What matters to me \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003eThe place I die is important to me:\u003cbr\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli style=\"list-style-type: none;\"\u003e\n\u003cul\u003e\n\u003cli\u003eYes\u003c\/li\u003e\n\u003cli\u003eNo \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003eWhen I am dying I would prefer to be cared for:\u003cbr\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli style=\"list-style-type: none;\"\u003e\n\u003cul\u003e\n\u003cli\u003eat home, which for me is:\u003cbr\u003e\n\u003c\/li\u003e\n\u003cli\u003ein hospital\u003c\/li\u003e\n\u003cli\u003ein a hospital-level care facility (residential care)\u003c\/li\u003e\n\u003cli\u003ein hospice\u003c\/li\u003e\n\u003cli\u003eI don’t mind where I am cared for\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003eOther details I would like you to know:\u003cbr\u003e\u003c\/p\u003e\n\u003ch3\u003eMy treatment and care decisions\u003c\/h3\u003e\n\u003ch4\u003eThis section is best completed with help from a doctor, nurse or specialist.\u003c\/h4\u003e\n\u003cp\u003eSometimes treatments can be both helpful and harmful. They may keep you alive, but not conscious, or make you feel a bit better for a short time, but cause you pain. Your health care team will only offer treatments you will benefit from.\u003cbr\u003eIf I am\u003cstrong\u003e seriously ill\u003c\/strong\u003e and not able to make decisions for myself, the following best describes the care I would like to receive. If I request a treatment that will not benefit me, I understand the health care team will not be required to provide it.\u003cbr\u003e\u003cstrong\u003eSeriously ill\u003c\/strong\u003e to me means:\u003cbr\u003eChoose only ONE of these five options:\u003cbr\u003e\u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003eI would like my treatment to be aimed at keeping me alive as long as possible. I wish to receive all treatments that the health care team think are appropriate to my situation. The exceptions to this would be: \u003cbr\u003eIf required and appropriate I would want CPR to be attempted:\u003cbr\u003eYes\u003cbr\u003eNo\u003cbr\u003eI will let my doctor decide at the time \u003c\/li\u003e\n\u003cli\u003eI would like my treatment to focus on quality of life. If my health deteriorated I would like to be assessed and given any tests and treatments that may help me to recover and regain my quality of life, but \u003cstrong\u003eI do not want to be resuscitated.\u003c\/strong\u003e \u003cbr\u003eFor me, quality of life is:\u003c\/li\u003e\n\u003cli\u003eI would like to receive only those treatments that look after my comfort and dignity rather than treatments that try to prolong my life. \u003cstrong\u003eI do not want to be resuscitated. \u003c\/strong\u003e\n\u003c\/li\u003e\n\u003cli\u003eI cannot decide at this point. I would like the health care team caring for me to make decisions on my behalf at the time, taking into account what matters to me and in close consultation with the people I have listed in \u003cstrong\u003eIf I am unable to make decisions\u003c\/strong\u003e\n\u003c\/li\u003e\n\u003cli\u003eNone of these represent my wishes. What I want is recorded in my advance directive on page 6.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003eI choose option number\u003cbr\u003e\u003c\/p\u003e\n\u003ch3\u003eMy advance directive\u003c\/h3\u003e\n\u003cp\u003eIf you have treatment and care preferences for specific circumstances or you want an advance directive, please write the details below.\u003cbr\u003eAn advance directive is a way of recording, before you need them, specific treatments you would or would not want in different situations if you were no longer able to speak for yourself.\u003cbr\u003eIf you can’t speak for yourself, it is the responsibility of your health care team to apply your advance care plan and any advance directive. When applying the advance directive, they must be confident that you:\u003cbr\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003efully understood what you were asking for\u003c\/li\u003e\n\u003cli\u003ewere free from influence or pressure from someone else\u003c\/li\u003e\n\u003cli\u003emeant this to apply to the current situation.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch3\u003eSigning my advance care plan \u003c\/h3\u003e\n\u003ch3\u003eAfter my death\u003c\/h3\u003e\n\u003cul\u003e\n\u003cli\u003eMy wishes for organ and tissue donation, if appropriate:\u003c\/li\u003e\n\u003cli\u003eMy wishes for caring for my body immediately after death:\u003c\/li\u003e\n\u003cli\u003eAfter I die I would like to be:\n\u003cul\u003e\n\u003cli\u003eburied\u003c\/li\u003e\n\u003cli\u003ecremated \u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003eFor my funeral or tangi I would like:\u003c\/li\u003e\n\u003cli\u003eI would like my last resting place to be:\u003c\/li\u003e\n\u003cli\u003eThis is important to me because:\u003c\/li\u003e\n\u003cli\u003eI don’t mind. I would like the decision to be made by:\u003c\/li\u003e\n\u003cli\u003eThings I would like my loved ones to know:\u003c\/li\u003e\n\u003cli\u003eMy will and other important things can be found:\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch3\u003eKarakia\u003c\/h3\u003e\n\u003cp\u003eKua tipu ngā rākau\u003cbr\u003eKua pūāwai ngā hua\u003cbr\u003eKua waiata ngā manu\u003cbr\u003eKua tau te wao\u003cbr\u003eKua tau, kua tau, kua tau e\u003cbr\u003eHaumi e, hui e, tāiki e\u003c\/p\u003e\n\u003cp\u003eThe trees have grown\u003cbr\u003eThe flowers have bloomed\u003cbr\u003eThe birds have sung\u003cbr\u003eThe forest has settled, it is settled\u003cbr\u003eLet the peace be amongst us\u003cbr\u003eLet us all be one\u003c\/p\u003e\n\u003cp\u003e\u003ca href=\"https:\/\/www.myacp.org.nz\/\"\u003eAdvance care planning\u003c\/a\u003e\u003cbr\u003e\u003c\/p\u003e","brand":"HealthEd","offers":[{"title":"Default Title","offer_id":49825151779044,"sku":"HE3322","price":0.0,"currency_code":"NZD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0102\/6916\/3582\/files\/HE3322.png?v=1788932563","url":"https:\/\/healthed.govt.nz\/products\/my-advance-care-plan-digital-english-he3322","provider":"HealthEd","version":"1.0","type":"link"}