Planning for end-of-life decisions with your patients Empower patients to communicate their end-of-life decisions

What is an end-of-life letter? End-of-life letters help to facilitate important conversations about end-of-life care plans between patients, families and caregivers.

What does an end-of-life letter cover? How the patient makes medical decisions The type of medical care the patient wants and does not want in their final days How to handle palliative sedation Any other information the patient wants included

Four steps to use end-of-life letters in your practice 1 Prepare your practice to use the letter 2 Share the letter with patients and their families 3 Discuss each patient’s completed letter and add it to the chart 8 4 Periodically update the letter as appropriate

Empower your patients and your practice Initiating an end-of-life letter conversation: use this tool to begin the end-of-life letter conversation with your patients Empower your patients and your practice

How is it working at other practices? Stanford, CA Steps in Practice Summary - Stanford University Department of Medicine in Stanford, CA April 2015: Stanford University Department of Medicine developed the letter template to guide patients through the process of making end-of-life decisions Complement to an advance directive talk about what matters to them on a personal level unrelated to their medical care, describe their preference for how they make medical decisions, etc. Families and patients appreciate the opportunity to convey their decisions and preferences through the letter At Stanford, a large multi-disciplinary committee is working to implement the letter in both the inpatient and outpatient settings (it is also EHR-compatible)

For additional resources, frequently asked questions and implementation support, visit www.stepsforward.org!