Advanced Care Planning

If you are like most adults in America, you plan and prepare for various major life events from attending post-secondary learning institutions to commitments in relationships and raising a family to eventually retiring from a career. Yet, only about one-third of adults plan for how they want their health care to be delivered when they become seriously ill even if they are

Many people find it hard to talk about illness and death. That does not mean you should put off planning. Advance care planning is a way to make sure your medical care matches your values and wishes. It also helps the people who will speak for you if you cannot speak for yourself.

What is advance care planning?

Advance care planning is choosing what kind of medical care you want in the future. It includes choosing someone you trust to make decisions if you cannot. It also means writing down your wishes so doctors and family know what matters to you.

Planning covers things like whether you want treatments aimed at curing an illness or treatments that focus on comfort. It covers whether you want CPR or breathing machines, and whether you want to be at home, in a hospital, or in a facility when seriously ill. Most importantly, it is about expressing what makes life worth living to you.

Important documents to consider

Here are common documents people use. Rules vary by state, so learn the names used where you live.

• Health care proxy or durable power of attorney for health care: Names the person who will make medical decisions for you if you cannot.
• Living will: Describes the kinds of medical care you would or would not want in certain situations. It is often used for end of life choices and life support preferences.
• POLST or similar medical orders: These are forms signed by your doctor that translate your wishes into medical orders for emergency situations. Not everyone needs one, but it can be useful for people with serious illness.
• Organ and tissue donation preferences: Your choice to donate can be recorded separately.

You do not have to fill out every form. The most important parts are naming a decision maker and sharing your values with family and doctors.

Talking with family and doctors

Planning is not only paperwork. It is a conversation. Those talks make sure your proxy understands what you want.

Start simple. Say what matters most to you. Use plain language. You might say:

• What types of life support you would accept or refuse.
• What quality of life would be unacceptable to you.
• Where you would prefer to receive care.

Tips for talking:

• Choose someone you trust and who is willing to speak for you. This could be a family member or close friend.
• Tell that person why you chose them and what you expect them to do.
• Bring up the topic with your doctor during a routine visit. Ask how different treatments might affect your daily life.
• Put your wishes in writing and give copies to your proxy, your doctor, and any facility where you receive care.

Keeping your plan up to date

People change. So do health situations and medical options. Review your plan when major events happen, such as a new diagnosis, a major change in health, or a move to a different state.

A few simple steps to keep plans current:

• Revisit your choices every so often and after health changes.
• Make sure your proxy is still willing and able to serve.
• Update written forms and give new copies to everyone who needs them.
• Ask your doctor to place a copy in your medical record.

Common concerns and how to handle them

Some people worry that making decisions now will lead doctors to stop caring. That is not true. Advance care planning is about getting the care you want, not avoiding care. It helps medical teams know whether to use aggressive treatments or focus on comfort.

Others fear upsetting family members. A clear, calm conversation can reduce conflict. Sharing your reasons and values helps loved ones understand your choices.

Finally, some think planning is only for very old or very sick people. Anyone over adulthood can benefit. Accidents and sudden illness can happen at any age.

Advance care planning is a gift to yourself and to those who will one day make hard choices for you. Start with a short talk, choose someone you trust, and put your wishes in writing. Small steps now bring peace and clarity later.