Your voice matters in healthcare decisions. What happens if you become unable to communicate your wishes? An advance care plan is your protection.
When there are emergencies or serious illnesses, tough decisions can come up in medical care. Should I be placed on a ventilator? Should I receive CPR? The answers may depend on many factors. An advance care plan allows you to express your wishes before these tough decisions arise. It enables others to take action based on your instructions.
“Research shows that you are more likely to get the care you want if you have conversations about your future medical treatment and put a plan in place,” says the National Council on Aging.
What is an Advance Care Plan?
An advance care plan (also called an advance directive) is a set of formal, legal documents that express your wishes. The most common documents are:
- A living will, which states your preferences for common medical treatments and life support
- A healthcare proxy (also called healthcare power of attorney), which gives someone you trust the authority to make decisions about medical care if you are unable to do so
An advance care plan may sometimes include other documents, such as a Do Not Resuscitate (DNR) order, or an order not to hospitalize.
How an Advance Care Plan Helps
Having an advance care plan in place gives you peace of mind that you can direct your own medical decisions under stressful circumstances. It keeps you in control. It also serves as a guide for your loved ones, so they do not have to agonize over making decisions.
Explains the National Council on Aging, “Studies show advance care planning can decrease the stress, burden, and grief experienced by those who may need to make medical decisions for others.”
Living Will
A living will outlines what type of life-support treatments you want. It comes into play when someone is terminally ill or unconscious. A living will can cover treatments such as CPR, ventilators, artificial nutrition and hydration, dialysis, and pain management.
How aggressive would you want the medical care to be? Would you want your life to be prolonged? While it is hard to consider questions like this, planning in advance helps you think about your values and your preferences up front. It allows loved ones to honor your choices.
Healthcare Proxy
Research shows that 3 out of 4 people will not be able to make some of their own medical decisions at some time in their lives. If this happens, “Doctors need to know who can make decisions for you,” explains the National Council on Aging.
A healthcare proxy is someone who can stand in for you if you are unable to voice your wishes or make medical decisions. It is also called healthcare power of attorney. It gives the legal power for healthcare decision-making to someone you have designated.
Your healthcare proxy can make medical decisions for you only if you are not able to make them yourself, as determined by a physician. A proxy can consent to treatment or plans, such as surgery, life support, or placement in a long-term care facility. A proxy can also refuse treatment, as guided by your stated preferences.
When choosing a healthcare proxy, look for someone you trust. The National Institute on Aging suggests questions such as:
- Do I trust this person with my life?
- Can this person handle conflicting opinions from my family, friends, and healthcare providers?
- Is this person comfortable asking questions of doctors, insurance companies, and other busy providers—and will this person stand up for me?
Free Planning Tools
There’s much to think about when you develop an advance care plan. The National Institute on Aging makes it easier with five advance care planning worksheets. Just download them or print them and note your answers to important questions. For example, you can consider:
- If an illness leaves you paralyzed or in a permanent coma and you need to be on a ventilator, would you want that?
- What if you are in pain at the end of life? Do you want medication to treat the pain, even if it will make you drowsy and tired?
- If you were at the end of life and dying, would you prefer to spend your last days in a healthcare facility or would you prefer to spend your last days at home?
The worksheets guide you through thinking about what matters to you and how you would want to handle various medical situations.
Other free tools for preparing an advance care plan are:
- Prepare for Your Care from the National Council on Aging, a step-by-step program with video stories that help you think through decisions. The program also helps you complete an advance directive form.
- Caringinfo.org provides a fillable advance directive form for people living in Indiana.
Be aware that a living will and a healthcare proxy assignment require witness signatures.
Legal Services
With free tools, you can create a living will and a healthcare proxy on your own. Some people choose to work with an attorney. If you need help, one resource is Indiana Legal Services, a nonprofit law firm that provides free civil legal assistance to eligible low-income residents throughout the state of Indiana.
Share Your Plan
Your living will and healthcare proxy work only if you share them. It’s a good idea to give copies to the person you’ve designated as your healthcare proxy, family members, and your doctor’s office.
An advance care plan is not final. You can update your plan at any time. Be sure to share the new plan with the same people.
Your voice matters. Making an advance care plan is a good way to ensure the healthcare you receive in the future is what you want. It is also a loving step to take for family members, easing their stress.