Advance-care Planning – It’s Never Too Early to Put Important Directives in Place
Q
: My elderly mother was in the hospital recently, and the nurses talked to her about advance care planning. I’d like to learn more about it for myself.
A: Advance care planning involves learning about the types of decisions that might need to be made about healthcare choices, considering those decisions ahead of time, and then, very importantly, letting others know about your preferences, often by putting them into an advance directive.
It is a common misconception that advance care planning — expressing your wishes regarding healthcare and for providers and facilities to respect those wishes — is something you do only in your senior years. But it always seems too early, until it’s too late. As healthcare professionals, we want to help people be prepared for any healthcare emergency by understanding the value of advance healthcare planning. The goal is to reduce the number of tragedies that occur when a person’s wishes are unknown, and improve the ability of healthcare facilities and providers to offer informed and thoughtful guidance about advance healthcare planning to their patients.
Q: What is a healthcare proxy?
A: A healthcare proxy is a simple legal document allowing you to name someone you know and trust to make healthcare decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions.
Q: What is an advance directive?
A: An advance directive, also known as a living will, is a legal document in which you state your wishes regarding end-of-life medical care — including the types of treatments you do and do not want such as ‘do not resuscitate’ (CPR) or ‘intubate’ to help the patient breathe — in case you are no longer able to make decisions or communicate your wishes. It goes into effect only if you are incapacitated and unable to speak for yourself. And it is considered to be a ‘living’ document, one you can amend as your situation changes because of new information or a change in your health.
Q: The nurse told me that I should plan ahead, too, as well as my children. At what age should you begin to make these decisions?
A: It’s never too early. Everyone over the age of 18 should have a healthcare proxy because anyone, no matter what age, could be involved in a life-altering accident or sudden life-threatening illness rendering them unable to make decisions or speak for themselves. Making your wishes known in advance by completing a healthcare proxy and an advance directive is extremely helpful to physicians in knowing what direction to follow in the event of family controversy over your treatment, which could otherwise lead to the courts becoming involved.
Q: Who should you consider as your healthcare proxy?
A: We often think of our spouse or parents as being able to make those decisions for us, but they may not be the right person because of the emotional burden their decision will carry. That’s why it is so important to put your wishes in writing, and to select someone who is emotionally able to carry out your wishes and who can answer any questions the doctor may have about your care.
For more information on advance care planning, visit the National Institute on Aging at www.nia.nih.gov and search ‘advance care planning.’ For a healthcare proxy, visit www.honoringchoicesmass.
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