Advance Care Planning

7 Things You Need to Know About Advance Directives for Your Patients

April 20, 2020

The most effective strategy for identifying what your advanced illness patients want near the end of life is to have a goals-of-care conversation early, regularly and matter-of-factly.

VITAS can help. So can these seven pointers about advance directives, the written documents that outline a person's healthcare preferences:

  1. Everyone over 18 should have an advance directive (e.g., a living will, durable power of attorney for healthcare decisions, Five Wishes document, POLST/MOLST document).
  2. They give patients control of their medical care if they can’t speak for themselves.
  3. They’re billable; Medicare reimburses you up to $86 to discuss end-of-life care with patients.
  4. The conversation is easier when the patient is healthy and alert. Ideally, families should be involved in the conversation to explore values, preferences and goals for care.
  5. They can be modified over time.
  6. Your patients are waiting for you to start the conversation.
  7. People who document their healthcare preferences in an advance directive are more likely to get the care they prefer at the end of life.1

Download a PDF of these tips >

Updated from an earlier version published on April 3, 2017.

1 National Institute on Aging. (2018). Advance Care Planning: Healthcare Directives. https://www.nia.nih.gov/health/advance-care-pl