Our first blog on advance care planning (ACP) focused on creating an end-of-life care plan. ACP can give you peace of mind. It gives you control over future health care decisions and the type of care you want. It can also help reduce health care disparities for people in communities of color because you work with your doctors to make health care decisions that align with your personal values.
This blog focuses on five things you can do after ACP to help ensure that your plan is followed:
- Share your ACP wishes with loved ones.
- Choose a health care representative.
- Identify the type of health care interventions you want.
- Formalize your health care decisions and share them.
- Revisit your health care decisions if things change.
1: Share Your ACP Wishes with Loved Ones
Once you know your end-of-life care plan, you should talk about it with your loved ones. Set aside time where this will be the only topic of discussion. It might take more than one meeting to get everyone comfortable talking about these issues. It’s normal for people to get sad or upset. Try to be patient and understanding.
Sharing your end-of-life care plan can help you identify who is able to accept your wishes and who might have difficulty accepting them. After your loved ones know your plan, start thinking about who could advocate for you as your health care representative.
2: Choose a Health Care Representative
The legal term for a health care representative is Power of Attorney (POA) for health care. Some health care settings may also use terms like Health Care Agent, Health Proxy, or Surrogate Decision Maker.
The POA for health care is responsible for making health care decisions if you can no longer make decisions for yourself. Having a POA for health care lets doctors know that someone will be advocating for your wishes. And when it comes to end-of-life care, most doctors want to talk through these decisions with another person.
Although choosing a POA for health care is one of the best ways to protect your end-of-life wishes, many people, especially in communities of color, do not have a POA for health care.
When it comes to selecting a POA for health care, most people choose a spouse, adult child, or close friend. You can specify if you want multiple people involved in discussing your health care (for example, if you have several children). But the final responsibility for making decisions will still go to one person.
Once you choose your POA for health care, meet with your loved ones again. Let them know who you’ve chosen to be your POA for health care. Make sure they understand this is the only person with legal authority to make medical decisions for you.
3: Identify the Type of Health Care Interventions You Want
Advance directives are documents that specify the medical care you want to receive. A living will is the most common type of advance directive. A living will states your preferences for palliative and hospice care. It also confirms whether you want to use life support interventions such as feeding and breathing tubes, or if you want your care team to perform cardiopulmonary resuscitation (CPR) if your heart stops. Your doctor can explain the benefits and risks of each so you can decide what’s best for your situation.
Advance directives are typically used to plan for an illness or accident that may occur in the future. But when these situations become your reality, you can take additional steps to protect your end-of-life decisions. Talk to your doctor to learn more about these options.
4: Formalize Your Health Care Decisions and Share Them
Forms are available to document your POA for health care, living will, and advance directives. Hospitals and other care facilities require this paperwork if medical decisions need to be made on your behalf. This signed paperwork helps ensure that medical staff will make decisions that reflect your wishes.
This paperwork is very important, especially if you have specific end-of-life wishes or designate a friend or unmarried partner as your POA for health care.
There are lots of free resources you can use to prepare this paperwork. Information about POA for health care, living wills, and advance directives can be found at:
- Caring Info
- Five Wishes
- Your state or city Department of Aging
- Spiritual and practical guidance
Take some time to go through these resources. If you have questions about how to fill out the forms, ask your doctor for guidance.
In most cases, these forms are state-specific. If you might move to another state to receive end-of-life care, you should complete forms for that state as well as the state you currently live in.
Once the forms are completed, make paper and digital copies for your records. Share these forms with your loved ones and your doctors. Make sure that your POA for health care has digital copies of all forms. Having easy access to these forms allows you to get the care you want without delay.
5: Revisit Your Health Care Decisions if Things Change
Things change. And health care decisions are no different. If, at any time, you want to update these documents or your POA for health care, you can do so. Review these documents regularly to make sure they reflect your current wishes and values.
It’s Time to Start Planning
The importance of ACP cannot be underestimated. This is especially true for people in communities of color, where disparities in access to the full range of care plus health care bias can continue through end-of-life care. ACP can reduce the impact of these because you set your health care expectations — on your terms, in accordance with your values. With a living will and advance directives to guide medical decision-making, and a trusted person as your POA for health care, you can receive the end-of-life care you want.