Services (Home Health Aide, Palliative Care, Hospice, Long-term Care, etc.) Life Sustaining Treatments (Artificial Nutrition, Mechanical Ventilation, CPR, Dialysis) Use framework (A-C) below to guide discussion for each service or LST discussed: A. Assess Understanding me what you know about .” “Tell have providers told you about ?” “What B. Provide Information (as appropriate) Use education materials as needed. C. Establish Next Steps (as applicable) Write down questions for the patient to address with their practitioner. Discuss referral process to other discipline(s)/team member(s)/specialty. Summarize what has been discussed. Determine which of the following are needed: today’s conversation in a follow-up visit Continue  Create new advance directive  Discuss service(s) in more detail  service(s): Which Make referral(s):  Follow-up with medical practitioner:  Additional information on medical condition(s)  Additional information on life sustaining treatment(s)  Consider life-sustaining treatment plan  state-authorized portable orders Consider Specific questions to address:
Services (Home Health Aide, Palliative Care, Hospice, Long-term Care, etc.) Life Sustaining Treatments (Artificial Nutrition, Mechanical Ventilation, CPR, Dialysis) Use framework (A-C) below to guide discussion for each service or LST discussed: A. Assess Understanding “Tell me what you know about .” “What have providers told you about ?” B. Provide Information (as appropriate) Use education materials as needed. C. Establish Next Steps (as applicable) Write down questions for the patient to address with their practitioner. Discuss referral process to other discipline(s)/team member(s)/specialty. Summarize what has been discussed. Determine which of the following are needed: Continue today’s conversation in a follow-up visit   Create new advance directive  Discuss service(s) in more detail Which service(s):  Make referral(s):  Follow-up with medical practitioner:  Additional information on medical condition(s)  Additional information on life sustaining treatment(s)  Consider life-sustaining treatment plan Consider state-authorized portable orders Specific questions to address: