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Advance care planning

Preparing for end-of-life care

 

Health crises happen. They don't happen to all of us, but they can happen to any of us. And if a crisis is severe enough to rob us of our ability to communicate, we have no say in the care we receive.

 

We may not be able to prevent a crisis from happening, but we can prevent being voiceless about the care that follows.

 

Formally communicating your wishes should the unthinkable happen is called advance care planning. It's a way to take care of yourself as well as those you love, those who love you. When you set up an advance directive – a legal document that describes your wishes for end-of-life care – you still have your voice.

How to create your advance directive

Here are the steps you’ll follow to create your advance directive:

 

  1. Think carefully about the type of care you would like to receive and where you would like to get that care.

  2. Discuss these wishes with your loved ones and doctors.

  3. Choose someone to be your health care agent (sometimes referred to as a health care proxy). This should be someone you trust to make decisions about your care if you aren’t able to.

  4. Put all of this in writing to formally document your wishes and share it with your loved ones, health care agent, and doctors.

Help in getting started

To help with the often difficult task of getting started, take a look at Caring Conversations: Making your healthcare wishes known published by the Center for Practical Bioethics. This booklet gently guides you through the process of creating an advance directive, and provides information about:

 

 How to think about the type of end-of-life care you would prefer

 

 How to talk to your family about your wishes

 How to choose a health care agent and what the agent's role is
 

 

The booklet also contains the following two forms:

 Durable power of attorney for health care decisions

 Health care treatment directive form

 

Because legal requirements are different from state to state, we suggest you visit CaringInfo to download state-specific versions of these forms.

Other resources about advance care planning

 

There are many valuable resources that can help you with advance care planning. Whether you prefer an internet browser or your local library, a little research pays off. Here are a few options to help you get started.

The Conversation Project

Access a "starter kit" at the Conversation Project to help you begin to identify and communicate your end-of-life wishes. This site also hosts the "Imagine"  video presentation that gives an overview of advance care planning and why it is so important.

CaringInfo

The CaringInfo website offers resources such as brochures, advance directive forms, and instructions for each state.

American Hospital Association

Get answers to questions about advance directives compiled by the American Hospital Association in their Put It in Writing brochure.

Portable Medical Orders for Life-Sustaining Treatment (POLST)

A POLST (or MOLST) is a medical order form (similar to a prescription) that relays instructions between health professionals about a patient's care. The signed POLST form stays with the patient and is to be honored by health professionals in any clinical care situation. 

 

The POLST is not the same as an advance directive. While an advance directive is a comprehensive document that covers a wide range of health care decisions, a POLST form is focused on end-of-life decisions that require immediate medical attention. For instance, it may specify whether you want to receive CPR, antibiotics, or be put on a ventilator.

 

Find out more about MOLST in Massachusetts.