Advance care planning is something most of us don’t think about when we’re young and healthy. However, it’s something that’s not just for older people. No matter how old you are, a medical crisis could leave you in a state where you’re too ill to make healthcare decisions for yourself. Advance care planning is an important step in ensuring you receive the care you would want, even if you’re unable to speak for yourself, says Chrissy Ross, Executive Director of Bridges® by EPOCH at Mashpee.
“Oftentimes, we don’t think about medical treatment and decisions until we’re actually facing a situation where it’s required,” she explains. “Unfortunately, if that situation is one where you’re not capable of making those decisions, the responsibility will fall to family members, which can cause uncertainty and stress for them, because they may not know what decisions you would want for yourself.”
Chrissy says that everyone should take time to do advance care planning, especially if you have diseases that run in your family such as Alzheimer’s disease or other forms of dementia. “If you know that health issues run in your family, it makes sense to think about what you’d like to happen if and when certain situations arise,” she says. “Setting down your wishes and directions can help take some of the burden off family and friends, while also giving you peace of mind that your wishes will be followed.”
What Is Advance Care Planning?
Advance care planning is when an individual sets down, in writing and otherwise, the types of healthcare decisions they would like to have made in certain situations. This involves certain legal documents that will only go into effect if a person is incapacitated or otherwise unable to make their own decisions.
“We encourage individuals who have been diagnosed with dementia to advance plan as early as possible, because it will allow them to express their values and wishes with regards to future care and end-of-life care,” she says. “It’s helpful to think of it as a living document that can be adjusted as a situation changes, due to new information or changes in health.”
Chrissy says a good way to start is by thinking about what treatments you would or would not want in a medical emergency or care situation. For example, what would you like to happen if your health or cognitive function deteriorates to the point that you need a significant amount of care? What about if you suffer some sort of health crisis like a stroke, heart attack or cancer diagnosis? If you’re able to do so, consider speaking with your primary physician about how your current health needs and issues might influence your future healthcare. It’s important to note that, if you have Medicare, discussing advance care planning with your doctor is a free service during your annual wellness visit (and it may be the same case with private health insurance – you’ll just need to check your policy).
Chrissy says that your personal values and morals should help guide you in considering treatment decisions. “What’s your ultimate goal for your quality of life?” she asks. “For those with a dementia diagnosis, at what point would you want to be moved into a memory care assisted living facility? There are no right or wrong answers; only what you feel in your heart is right for you.”
It’s important to remember that your decisions on how your healthcare should be handled may be different now than in the future. That’s where the concept of a “living document” really comes into play. It allows you to provide your instructions for different types of situations while also allowing you the flexibility to change them if your viewpoint or situation changes.
What To Include in Advance Care Planning
The two main elements of an advance directive include a durable power of attorney and a living will. There are two different types of “powers of attorney”: financial and health-related. In advance planning, we’re speaking specifically to the one that deals with healthcare. While there are other documents you can put together during your advance planning, these are the two that are the most important.
A living will is a document that lists out how you want to be treated in certain situations – such as if you’re dying in or in a situation where you can’t make informed choices about your treatment. A durable power of attorney, in healthcare matters, is a legal document that names your healthcare proxy – a person who you’ve appointed to make medical decisions on your behalf if you’re unable to do so. Other documents you might want to include in your advance planning can induce any information about DNRs, organ and tissue donation, advance directives and others.
Once you’ve made your decisions, the next step is to meet with a lawyer and officially fill out forms so your wishes will be followed. Different states can have their own required forms, and your local Area Agency on Aging can help you locate them. Another way to gain the information you need is by calling the Eldercare Locator toll-free at 1-800-677-1116.
What to Do Once You’ve Set Up Your Advance Plan
Once you’ve determined the decisions you’d like to have followed for the future, the next step is to make sure that your important people have copies of the documentation. Make sure that your lawyer, your power of attorney and your primary physician have copies of all your paperwork. But don’t stop there. Be sure to talk with close family members and friends about your wishes for the future and what you’d like to happen in certain instances. Err on the side of more information being better than less.
Chrissy says that, once you’ve set your advance care decisions down, be sure to review them on a regular basis. “If you’re on the younger side of things, it’s good to review your plans every decade or so,” she says. “If you’re older, every year might be a good option. If you have a life change, such as a divorce or remarriage, it’s a good idea to revisit your decisions then, too.”
Chrissy urges individuals to remember that an advance directive is only used in dire circumstances. “Some people can get anxious about advance planning because they’re afraid their decisions are set in stone,” she says. “Remember that these plans are only used if you’re in a situation where you’re unable to make decisions for yourself. Think of it as an insurance policy for your hopes, desires and wishes. None of us know what the future may hold, but having your wishes spelled out in advance planning will give you and your family members some peace of mind.”
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