Why you shouldn’t wait to make an advanced care plan

When you’re healthy, it’s natural not to think about what might happen if you experienced a serious illness or injury. But this is actually the best time to consider the many complex issues that surround a life-threatening health issue. What steps should you take now to ensure you receive the care you want if you’re not able to make healthcare decisions for yourself?

What types of medical care do you or don’t you want?

An advanced care plan allows you to decide what types of medical treatments and interventions you’re willing to undergo if you’re not able to make these decisions for yourself. For example, if you were in an accident and suffered a brain injury that made you unable to breathe without a ventilator, would you want this intervention? If so, how long would you want to stay on the ventilator if your physician believed that it was unlikely that you would recover to the point of being able to breathe or function on your own?

Other types of medical care that you should consider include:

• the use of a feeding tube and/or an IV to provide artificial hydration
• cardiopulmonary resuscitation or the use of a defibrillator in the event that your heart stops beating
• the use of sedation or pain medication if you are dying

It’s also important to think about how long you want to undergo active treatment for your illness or injury if your physicians believe that you are unlikely to recover. Many people choose to receive hospice care, that is, care that is not focused on a cure, but rather on relieving symptoms so that you have a better quality of life.

Who do you want to make medical decisions for you?

It’s important that the person you choose to make medical decisions for you if you are unable to make them yourself will be willing to follow your wishes, so have a frank discussion with any candidates before making your decision. This person is known as a healthcare proxy. You can decide whether your proxy can make all healthcare decisions on your behalf or only specific decisions.

There are a few legal requirements for a healthcare proxy. A proxy must be a competent adult you trust but who does not have any potential conflicting obligations, such as one of your healthcare providers. It’s also wise not to appoint joint proxies because having two people who need to be consulted on every decision can complicate and slow the process.

What documents do you need to have in place?

To ensure that your wishes are followed, you need to complete several legal documents, including:

• living will or advance directive that outlines what types of medical care you do and do not want if you are dying or not expected to regain consciousness and under what circumstances these decisions should be applied
• durable power of attorney for healthcare, which names your healthcare proxy
• Do Not Resuscitate Order (DNR), if you don’t want CPR or other measures taken if your heart stops
• organ and tissue donation card, if you want to be an organ donor

You should keep a copy of your advance directive in your files. In addition, make sure all of these people have a copy so your wishes will be followed:

• your healthcare proxy
• your primary caregiver
• your primary physician
• the state advance directive registry if there is one in the state or states where you live

Once you have your advance care plan in place, it’s a good idea to review it every few years to make sure that you’re still comfortable with your choices. If your preferences change, you’ll need to create new documents and distribute them to all the people listed above.

By planning ahead, you’ll have peace of mind that you’ll receive the medical care you want and your family will be able to focus on making sure your wishes are respected.