Provides assistance with advance care planning for individuals who want to express their wishes regarding future medical treatment should they become incapacitated and/or to name the individual they would like to make health care decisions on their behalf.

Outlines a step-by-step approach to advance care planning, including appointment of a health care agent, documentation of health care goals and treatment priorities (living wills), and consideration of medical orders to limit treatment at the end of life. Trainings and presentations are available for health care professionals, health care facilities, and community groups.

Provides information about how to create, register, and make changes to an advance directive. Also, provides instructions and order forms for a Do Not Resuscitate (DNR) order.

Provides holistic care services to all community members that may include the following: Nursing, Behavioral Health and Physical Health Coaching services: Nutrition education, exercise education and counseling, short-term behavioral counseling, Diabetes education, individual health coaching, medication management, weight management-individual and group support, smoking cessation, Advanced Directives, Fall Safety assessments, medical transportation and dental solutions. Community Connections Community Health Team also provides Resource Advocates who will assist with completing applications for the following services and assistance: health insurance (VT Health Connect and Medicare and Medicare D comparisons), SSDI/SSI, and prescription costs, as well as application assistance for housing, food, and utilities. The team also includes VT Health Connect navigators and assistors, as well as care managers for individuals who require support maintaining independence and stability within the community.

Educates Vermonters about end-of-life options, including medical aid in dying under Vermont's Act 39. This law enables mentally competent adult Vermont residents who have a terminal illness with 6 months or less to live with the option of requesting medical aid in dying. Provides advice and assistance to both doctors and patients. Offers online and printed materials that include A Vermonter's Guide to End-of-Life Decision-Making as well as a Pocket Guide to Medical Decision-Making and provides suggestions for patients on how to talk to their doctor. Also advocates to influence policy, regulations, and practices that affect the terminally ill.

Provides holistic care services to all community members that may include the following Nursing, Behavioral Health and Physical Health Coaching services: Nutrition education, exercise education and counseling, short-term behavioral counseling, Diabetes education, individual health coaching, medication management, weight management-individual and group support, senior social isolation groups, Senior/ Disabled medical wellness home visits, smoking cessation, Advanced Directives, Fall Safety assessments, medical transportation and dental solutions. Grace Cottage's Community Health Team also provides a Resource Advocate who will assist with completing applications for the following services and assistance: health insurance (VT Health Connect and Medicare and Medicare D comparisons), SSDI/SSI, and prescription costs, as well as application assistance for housing, food, and utilities.

Provides programs that help individuals to remain in their homes and connected to the community. Services may include transportation to medical appointments, shopping, and friendly visits, community nurse visits, referrals for other services, wellness classes and activities.