Understanding Advance Care Planning

Man and woman sitting at table looking at electronic tablet.

Advance care planning is the process of deciding one’s own future medical care. It helps to make sure that if you can’t speak for yourself, your wishes can still be carried out. The plan is a series of legal documents that note a person’s wishes. The documents vary by state. Advance care planning should be discussed at a regular office visit with your primary care provider before an acute illness. Advance care planning is encouraged when a person has a serious illness that is expected to get worse. It may also be done before major surgery. And it can help you and your family be prepared in case of a major illness or injury. Advance care planning helps with making decisions at these times.

A healthcare proxy is a person who acts as the voice of a patient when the patient can’t speak for himself or herself. The name of this role varies by state. It may be called a Durable Medical Power of Attorney or Durable Power of Attorney for Healthcare. It may be called an agent, surrogate, or advocate. Or it may be called a representative or decision maker. It is an official duty that is identified by a legal document. The document also varies by state.

Why is advance care planning important?

If a person communicates his or her healthcare wishes:

  • He or she will be given medical care that matches his or her values and goals.

  • Family members will not be forced to make decisions in a crisis with no guidance.

Creating a plan

Making an advance care plan is often done in 3 steps:

  • Thinking about one’s wishes. To create an advance care plan, you should think about what kind of medical treatment you would want if you lose the ability to communicate. Are there any situations in which you would refuse or stop treatment? Are there therapies you would want or not want? And whom do you want to make decisions for you? There are many places to learn more about how to plan for your care. Ask your healthcare provider or legal advisor for resources.

  • Picking a healthcare proxy. This means choosing a trusted person to speak for you only when you can’t speak for yourself. When you cannot make medical decisions, your proxy makes sure the instructions in your advance care plan are followed. A proxy does not make decisions based on his or her own opinions. They must put aside those opinions and values if needed, and carry out your wishes.

  • Filling out the legal documents. There are several kinds of legal documents for advance care planning. Each one tells healthcare providers your wishes. The documents may vary by state. They must be signed and may need to be witnessed or notarized. You can cancel or change them whenever you wish. Depending on your state, the documents may include a Healthcare Proxy form, Living Will, Durable Medical Power of Attorney, Advance Directive, or others.

The family’s role

The best help a family can give is to support their loved one’s wishes. Open and honest communication is vital. Family should express any concerns they have about the patient’s choices while the patient can still make decisions in the event that his or her illness prevents him or her from communicating those wishes at a later time.