“The only certain thing in life is death, with only the timing varying from one person to another…and yet we never seem to be prepared for it.”  - Daniela Norris -

Advance care planning empowers you to make your own decisions about your medical care.

In case of an accident or a serious illness, physicians will turn to your close ones to make decisions for you. People tend to make bad decisions when they are in grief and confused. That’s why it’s important to plan ahead. 

I’ve been working in the healthcare industry for over twenty years. I’ve seen the struggle, the confusion, the heartbreak, and even the arguments caused by not knowing what to do when a loved one is unable to convey their wishes.  

In this article I will discuss the what, when, who, and why of Advance Care Planning.

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What is Advance Care Planning?

Advance care planning (ACP) is the process in which you establish instructions for your health care and communicate with your loved ones for future decisions about your medical care in case of a serious illness, a medical emergency, or become unable to communicate your wishes. 

An advance care plan may include: Future consent, rejection, and/or termination of medical treatment, DNR (Do Not Resuscitate) orders, end-of-life decisions and more.

This process can be very important to convey your preferences. Also, when it comes to your future medical care your advance care plan should be centered on your personal values, beliefs, and goals.

It’s important to remember that if you already have an advance care plan it should be revised and updated at least once a year or at any moment your health condition changes.

Why should I have an Advance Directive?

An advance directive is a legal document that states your wishes and provides instructions for your desired future care.

Having an advance directive is planning ahead. With an advance directive in place you will avoid misunderstandings, confusion, or disagreements about the choices you would want when it comes to your health care. 

You will also relieve your loved ones of the weight of last-minute decisions, usually made under pressure and grief. This legal document would be used in case you are unable to communicate your decisions and wishes.  

The most common Advance Directives are the Living Will and the Power of Attorney for Healthcare.

Rituals based on your belief system may also be included in your advance directive.

What is Included In An Advance Directive?

Advance directives are written/spoken instructions and/or specific directions. They usually include Medical Care instructions, Living Wills, Power of Attorney, and Rituals.

Power of Attorney for healthcare - The power of attorney for healthcare is a legal document that names a specific person who can make decisions for you in case you are unable to communicate them yourself. This person is also known as a health care proxy. The person of your choosing as your health care proxy or power of attorney (POA) will ensure your care and treatment preferences are followed according to your stipulated decisions. 

NOTE: There may be some restrictions in place on who you can name as your health care proxy depending on where you live.

Living Will - The living will is also a legal document with instructions on what health care treatments you desire in case you cannot communicate them yourself. Unlike a Last Will, the Living Will takes effect while you’re still alive. This document will ensure your medical decisions are respected. 

It’s important to know that not all advance directives have to be a written document. Spoken directions in the presence of a witness are also valid as advance directives.

Who Should Have an Advance Care Plan?

Planning ahead is for everyone! 

A “you never know” is reason enough to have an advance care plan. However, it is particularly important if you have been diagnosed with a chronic or terminal illness, have multiple health conditions, serious medical issues, or if you're older. 

Another thing to consider is your family members' communication with one another. Let’s think of it this way, relationships are sometimes complicated. 

Do you think everyone in your family will agree if a certain decision about your medical care has to be made? Or will it cause dissent among them? 

Do you have estranged family members? People who will most likely be contacted to make important decisions on your behalf. Do you feel comfortable leaving your future decision making to others?

Who Should Have a Copy of my Advance Directive?

If you have a written advance directive in place first and foremost your first copy should be provided to your chosen health care proxy. But you can also share copies with anyone you prefer and trust.

However, besides your health care proxy it is recommended to share it with your health care providers, your physician, a lawyer, a clergy of your belief system, and other loved ones.

When Should Advance Care Planning Be Done?

It’s never too early to make an advance care plan. No one ever knows for sure what the future holds. 

Accidents can happen at any given moment. Serious illnesses sometimes hide in our bodies for years then come at you when you least expect it. Both situations can also happen at any age. 

Besides, life circumstances change everyday. 

How do I Create An Advance Care Plan?

You can start with a checklist. It’s important to have a clear idea about your preferences, your beliefs, your values, and your goals.

Organize any documents you may need in case of an emergency. Try to get your affairs in order to be able to make the necessary arrangements.

Talk to your loved ones and your doctor about your future health care and medical treatment. Hospitals also have representatives and medical personnel that can help you. 

You don’t need a lawyer to make an advance directive. But in case of having any legal concerns I would strongly recommend talking to one.

There are resources and forms available online depending on where you live.

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Final thoughts

Advance care planning is not just easy, it’s convenient for you and for those close to you.

In case of an emergency or a serious illness doctors will appeal to your loved ones or make their own decisions according to their evaluation and assessment. 

Those decisions may include certain medical treatments like blood transfusions, intubations/extubations, organ/limb removal, and so on. 

Some of these treatments may not be in line with your beliefs, values, or with your health care goals. 

So when it comes to making decisions about you and your medical care, planning ahead is the best decision of all.