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alliedacademies GASTROENTEROLOGY
International Conference on
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
Journal of Gastronenterology and Digestive Diseases | Volume 3
Page 26
Advance care directives are documents that state a people wishes for health
and personal care in a future time if they are unable to communicate them.
There are two types: instructional directives or living wills where people state
what they want done circumstances e.g. I don’t want CPR if my heart stops.
The second type of advance care directive is where people nominate another
to make decisions on their behalf if they are unable to do so. This is the “proxy
directive” like an enduring power of attorney for health care. Let ME Decide is
a book, now in its 27th edition, that contains an advance care directive that
allows individuals to give instructions and nominate another to make decisions
for them if they are incapacitated. This presentation will discuss data from
about twenty countries where we studied how physicians, nurses and the
public would make decisions for a man with dementia who was admitted to the
emergency department with an acute life threatening gastrointestinal bleed.
We report how choices vary depending on whether we are making decision
for unknown patients. family members or ourselves. The responses were
affected by age, training, culture. legal concerns and ethical beliefs. We also
systematically used Let Me Decide in nursing homes in Canada, Australia
and Ireland. Hospitalisations were reduced by 70%. This is one of the few
interventions that reduces hospitalisation, promotes patient autonomy, takes
family and health care professionals “off the hook” because they don’t have
to make these decisions, reduces mortality, reduces health care costs and
improves the quality of care at the end of life.
Biography
David William Molloy is M.B, , B.A.O. (1977);
M.R.C.P. IRELAND (1980); L.M.C.C. (May 1983);
F.R.C.P.(C) (1985) Internal Medicine and Geriatric
Medicine - graduated from UCC in 1977 and was
appointed as the Chair of the Centre of Gerontol-
ogy and Rehabilitation in September 2010. Prior
to this he was Professor of Medicine at McMas-
ter University, Canada and St. Peter’s McMaster
Chair in Aging. Professor Molloy has an extensive
publication history in Dementia and current re-
search interests include advance directives, clin-
ical trials in dementia and efficient use of acute
hospital services for older people.
“LET ME DECIDE” ADVANCE CARE
DIRECTIVE
David William Molloy
University College Cork, Ireland
David William Molloy, J Gastroenterol Dig Dis 2018, Volume 3