What I Need to Know—about Advance Care Planning
What is advance care planning?
Advance care planning is making decisions about the care you would want if you were unable to speak for yourself. The goal is for you to live well in a way that is meaningful to you.
These are your decisions to make. Regardless of what you choose for your care, your decisions should be based on your personal values, beliefs and preferences. It is important for you to openly discuss your choices with your loved ones so they are aware of your wishes.
The documents used in advance care planning are called “advance directives.” They fall into two categories: those that provide instructions regarding medical care and those that designate someone, known as a “proxy” or “surrogate,” who is authorized to make decisions for you when you are unable to do so yourself. Advance care planning means:
- Understanding possible future health choices
- Thinking about these choices and reflecting on what is important to you
- Talking about your decisions with loved ones and your healthcare providers
- Putting your decisions in writing
How to complete advance directives
- You do not need a lawyer to prepare advance directives.
- Make sure your advance directives accurately reflect your wishes.
- Get information on the types of life-sustaining treatments that are available and decide what treatments you would or would not want should you be unable to speak for yourself.
- Document your wishes by putting this information into writing using your state-specific advance directives forms.
- Share your personal values and wishes with your loved ones.
- Read the instructions carefully to ensure that you have included all of the necessary information, and that your documents are witnessed properly.
- Keep the original documents in a safe but easily accessible place, and tell others where you put them; you can note on the photocopies the location where the originals are kept.
- It is important to provide a copy to your healthcare providers, so they know your wishes and can make appropriate referrals to honor your choices.
Examples of advance directives
- A living will, which is a written statement of healthcare wishes to be carried out if you are unable to communicate (for example: decisions related to life support, disabling pacemakers or defibrillators, nutrition, dialysis).
- A healthcare proxy, sometimes called a “healthcare surrogate” or “healthcare power of attorney,” which allows you to name a family member or trusted friend to speak on your behalf and make decisions when or if you are unable.
Things to consider about advance directives:
- If you are in an accident or have an illness that leaves you unable to talk about your wishes, who will speak for you?
- Are there certain support measures you would or wouldn’t want if you were terminally ill?
- Completing advance directives allows you to tell your family, friends and healthcare providers about your wishes and personal beliefs concerning continuing or withdrawing medical treatments at the end of life.
- Conversations that focus on your wishes and beliefs will relieve loved ones and healthcare providers of the need to guess or deal with conflicting opinions about what you would want.
- Do not store your advance directives in a safe deposit box, because other people need access to them. Instead, provide copies to those individuals who are important to you and may assist in carrying out your wishes.
- Before your living will can guide medical decision-making, two physicians must certify that you are unable to make medical decisions and that you are in the medical condition specified in you state’s living will law. Other requirements may apply, depending upon your state.
- Before a medical power of attorney goes into effect, your physician must conclude that you are unable to make your own medical decisions. If you regain the ability to make decisions, your healthcare proxy or surrogate cannot continue to act on your behalf. Many states have additional requirements that apply only to decisions about life-sustaining medical treatments.
- Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one.
- You should review your advance directives periodically to ensure they still reflect your wishes.
- One state’s advance directive does not always work in another state. If you plan to spend a significant amount of time in more than one state, you should complete advance directives for each state you will be spending time in.
- You can locate your state’s advance directives at caringinfo.org.
When to call VITAS
- If you feel stressed and need to talk to someone for support
- If you need additional directions on how to complete advance directive documents
- If you need assistance locating your state’s forms
- If you do not understand the information in a family member’s advance directives
- If you have questions about end-of-life-choices.
If you have questions or concerns, please refer to your VITAS notebook for numbers to call, day or night.