Advance Care Planning
This Advance Care Planning guide was created to help you learn what advance care planning is, its importance, what steps are involved, and what happens when your advance care plan goes into effect. You’ll also find resources that are available to help you through the process.
What Is Advance Care Planning?
Advance care planning is the process of making choices about your future medical care and communicating your choices to others. ABTA encourages you to talk with your doctor, family members, and people you are close to about these important health care and medical decisions.
The outcome of advance care planning is typically one or more legal documents called advance directives. These are your written instructions about the type of care you would like to receive if you become unable to make health care decisions on your own. Advance care planning also includes identifying a person to whom you are designating your power of attorney for health care.
The Importance of Advance Care Planning: Advance Directives
You have the right to make decisions about the health care you get now and in the future. An advance directive is a written statement you prepare about how you want your medical decisions to be made in the future, if you are no longer able to make them for yourself. Advance directives should reflect your personal beliefs, values and preferences in your health care treatment. They also offer peace of mind in knowing that you have a plan in place and that your loved ones are aware of and understand your wishes. With clear instructions, your family and loved ones will be less likely to feel helpless, guilty, stressed or uncertain over critical decisions involving your medical care and treatment.
Starting the Planning Process
A good way to begin advanced care planning is to talk with a trusted doctor, nurse or social worker to learn more about life-sustaining treatments—measures that can keep you alive when your body cannot function on its own. Once you understand
the options that may be available, you can decide which ones you would want to receive under certain conditions. Be sure to ask questions until you feel you have the information you need. When you are ready, it’s important to discuss your wishes with your family and physician.
Help with advance care planning is available through government agencies, nonprofit organizations and other groups. Some offer worksheets to help you think about different issues and make decisions. (See the “Advance Care Planning Resources” section at the end of this guide).
Types of Advance Directives
The two main types of advance directives are the “living will” and the “power of attorney for health care.”
A living will is a document in which you specify the life-sustaining treatments you would like to receive if you are permanently unconscious, in a coma, or incapacitated. In your living will, you can state whether or not you would want such treatments as:
- CPR to restart your heart
- Mechanical ventilation to keep you breathing
- Nutrition provided “artificially” through a tube or intravenously if you can no longer eat or drink
- Dialysis if your kidneys fail
- Blood transfusions
- Antibiotics
- Pain medications
- Diagnostic tests such as x-rays
- Surgical procedures
By naming a power of attorney for health care, you are allowing someone to make medical decisions on your behalf if you cannot make them yourself. The person you appoint is known as your health care “agent” or “proxy” and he or she is responsible for decisions about your care, including the situations covered in your living will. You’ll want to choose someone you trust, such as a family member, partner or close friend. Make sure this person is willing and able to be your agent and to speak with medical and health care professionals on your behalf. In most states, you cannot name your doctor as your agent.
Living will forms and power of attorney for health care forms can be obtained from your physician, hospital, health department, state bar association, or hospice organization. Templates for these documents are also available as free internet downloads, and often even at office supply stores. Since requirements vary state by state, it's important to note that you you are using your state’s own specific forms so they will be legally recognized.
When Your Directives Take Effect
Your living will and power of attorney for health care can only take effect after your physician determines that you are no longer able to make medical decisions for yourself. At this point, your health care agent will be in charge of interpreting your living will and making all decisions about your medical care. If you recover your ability to make and communicate decisions, your health care agent will no longer need to speak for you.
Making it Official
Make sure to check your state’s laws regarding how to make the Advanced Directives official. Most states require a witness sign the documents along with you. Some states require the documents be notarized by a notary public. It is
important that you comply with your state’s requirements, whatever they are.
Keep your original documents in a safe place—but NOT in a safe deposit box since others will need access to them. Give copies of the originals to your doctor, your family and, especially, the person you have appointed as your health care agent. If at any time you revoke the documents and create new ones, provide these same people with the updated versions.
Different States, Different Documents
Legal requirements for advance directives vary from state to state. Nothing in this document is legal advice, nor does this document address state-specific legal requirements. You should consult a lawyer in your state or a state agency, or use forms that are specific to your state, to ensure that your advance directives will be legally recognized. Some states may honor another state’s forms, but some may not. If you spend a lot of time in more than one state, you might want to complete each state’s documents for the living will and power of attorney for health care.
“Five Wishes”—2 Directives in 1
Five Wishes is a form you can complete that serves as both a living will and power of attorney for health care. It is generally valid in the District of Columbia and 42 states (all except Alabama, Indiana, Kansas, New Hampshire, Ohio, Oregon, Texas, and Utah).
The Five Wishes form is easy to use and provides the following information:
- The person I want to make health care decisions for me when I can’t make
them for myself - The kind of medical treatment I want or don’t want
- How comfortable I want to be
- How I want people to treat me
- What I want my loved ones to know about my health care wishes
Available in 26 languages, you can obtain a copy of Five Wishes at www.agingwithdignity.org or 1-888-594-7437.
Advance Care Planning Resources
General Information:
Caring Connections
www.caringinfo.org
Center for Healthcare Decisions
www.chcd.org
American Academy of Family Physicians
www.familydoctor.org
Advance Directive Forms:
Caring Connections
www.caringinfo.org/stateaddownload
Aging with Dignity (Five Wishes)
www.agingwithdignity.org
National Resource Center on Psychiatric
Advance Directives
www.nrc-pad.org
To access a PDF of this information, please click Advance Care.
Last updated October 28, 2011
8550 W. Bryn Mawr Ave. Ste 550
Chicago, IL 60631
Phone: 773-577-8750
Fax: 773-577-8738
CareLine: 800-886-2282
E-mail: abtacares@abta.org