MCHCE supports healthy aging in place, for the Sisters of St. Joseph of Carondelet and the broader communities served by Fairview Health Services and HealthEast Care System.  MCHCE is at the cutting edge of designing advance care planning tools and improving the process of surrogate decision-making for all involved.


Two key areas of importance in MCHCE’s work:


Dementia-Specific Advance Care Planning

Dementia poses an unusual breadth of ethically challenging decisions – and warrants a new, broader kind of advance care planning.  In contrast with people with acute terminal illnesses, people with dementia tend to experience a long gradual loss of multiple cognitive and physical functions as well as changes in mood, behavior and personality. The burden of caregiving is notoriously high, the stakeholders tend to be numerous, and surrogate decision-makers often wish for more specific insights into the preferences of the person with dementia. Dementia-specific advance care planning is a new frontier, and one where MCHCE has been making a difference.


Surrogate Decision-Making

MCHCE focuses, in collaboration with its Sponsors, on improving the process of surrogate decision-making, whether in acute care or long-term care.  We regularly support providers and surrogate decision makers in clinical ethics case consultation.


Some of our recent work in healthy aging and end-of-life decision making includes:

  • Identifying systematic, responsive and cost-effective approaches to assuring healthy aging-in-place for the community
  • Researching and recommending evidence-based approaches to dementia-specific advance care planning that promote persons’ timely creation of directives and guidance for their agents, care partners, and providers
  • Developing and piloting new tools to improve the surrogate decision-making process for surrogates and providers
  • Participating in community-based initiatives to improve patient-centered care at the end of life