Assignment task: You are employed by the Alliance Community Centre as a mental health support worker.
Your client is an 80-year-old man, Jim Cardet. Jim has been referred by his general practitioner to your organisation. Your organisation has referred Jim to you to speak to him about advance care planning.
Background information
Jim is happily married to a 62-year-old woman, Shirley, who is employed fulltime. This is Jim's second wife; they have been happily married for 10 years. They are comfortable financially. He has 5 children to his first wife-ages 35 to 50, who are all living independently, with their own families. He is very fond of all his children and has good relationships with them all. He regularly keeps contact with them. However, his sons George and Frank live close by and are his closest family supports. His first wife died 10 years ago, and father died at an early age of heart failure. Jim witnessed the event as a child.
Jim has led an active life, working in retail until retirement at 60. Prior to his heart problems (culminating in the surgery) he was very active physically and socially-he used to play club tennis and golf, surf with his sons, and go fishing. He also had regular social group outings with other people. However, he is no longer able to perform these physical activities.
His symptoms include feeling low in mood and tired all the time, when his wife goes to work, he wants to just return to bed. Jim feels like he has no energy, and everything is an effort. He feels he is a burden to his wife, and she will tire of him. He is not sleeping well at night. He worries about everything, such as the car breaking down, getting to medical appointments, his children, his wife, and managing the shopping. He worries that the house is not clean enough, yet he cannot find the energy to do housework. When his wife does something, he feels guilty because he thinks he should be doing it.
Session information:
Jim has recently begun feeling his mortality as he is now past the age his father died. Jim heard about advance care planning through his general practitioner and feels it is time to put an Advanced Care Directive in place. However, he does not know much about advance care directives, what is involved, or the laws surrounding them.
Jim has said that he is fearful about leaving his family in making decisions about his care and end of life instructions. He loves his family but does not want his children to put their lives on halt for his age and health condition. He does not wish to be resuscitated with his heart or breathing as he feels he will be burden on his family. He hopes that his sons will help Shirley with her financial decisions and healthcare once he passes and when she needs the help.
Jim has reported that he has issues with his mobility as he does not exercise or do physical activities like he used to and worries he will experience a heart attack. He also reports that he worries about not being able to assist if something happens, such as the car breaking down or fixing things around the house.
Jim understands that he is nearing end of life but is saddened by the fact he will have to leave his family. Jim has stated that the most important thing to him would be to have his family with him when he passes.
Question 1: Discuss what information and resources you would provide about advance care directives, including their purpose and legal standing? - detailed please
Question 2: What information can you provide Jim to help him choose a substitute decision-maker and witness? Detailed please.