Advance Care Planning

Imagine reaching a point in your life when decisions about your care and treatment must be made, but you are incapacitated and unable to make them yourself. You might be badly injured, terminally ill or in the late stages of dementia. The decisions to be made might include what measures to take, if any, to extend your life, or when to stop treatment and provide you with only “comfort care.” 

If you are unable to make your own decisions, it is crucial for others – your loved ones and healthcare providers – to know what you would wish for yourself. Thinking about and stating those wishes in advance is called advance care planning.

Advance care planning is an important step that everyone should consider. You should take action now, while you are able. Decisions about end-of-life care are very personal and should be based on your values and beliefs. Letting your preferences be known ensures that others will not need to guess what you would want. It is a gift of peace of mind, both to yourself and to those who may be called upon to make those difficult decisions on your behalf. 

Advance Care Planning Involves:

• Learning about the kinds of decisions that might need to be made in various situations, 
• Considering those decisions ahead of time,
• Sharing your values with your loved ones, and
• Writing down your preferences in documents called advance directives. 

Advance directives are legal documents that go into effect only if you are incapacitated and unable to speak for yourself. You may have more than one kind of advance directive. An advance directive that includes end-of-life instructions is often called a living will. Another kind of advance directive is a healthcare power of attorney, which allows you to appoint as your healthcare agent someone you trust to make medical decisions on your behalf. 

In Minnesota and some other states, your doctor can also sign a physician order for life-sustaining treatment (POLST) that reflects the end-of-life wishes you have discussed with her or him. Advance care planning discussions with your physician are covered under Medicare.

Some of the situations you should think about and discuss with your family, your doctor and your healthcare agent include:

• Are there treatments you particularly want to receive or refuse?
• If your heart stopped, under what circumstances would you want doctors to use CPR to try to resuscitate you?
• When nearing the end of life, under what circumstances, or for how long, would you want to receive treatments such as antibiotics, kidney dialysis, mechanical ventilation (a breathing tube), tube feeding, or intravenous (IV) fluids for hydration? 
• Do you want to make organ or tissue donations upon your death, or donate your body for scientific study? 

You do not need a lawyer to complete an advance directive. However, to ensure that your wishes will be honored, you must carefully follow the steps required for advance directives by the state(s) you live in.

Advance care planning is important and meaningful. Research shows that people who document their preferences in an advance directive are more likely to get the care they prefer at the end of life than people who do not. And that’s an outcome worth planning for. 

This story is from the April 2017 issue of Northfield Retirement Community's newsletter, NRC Insights. Read the full issue here.