As a hospice physician, I encourage people – not just my patients, but my friends and family – to think about what they would want at the end of life. Today, there are so many ways to learn about those choices: books, movies, YouTube, articles, blogs, VITAS.com, the VITAS® Healthcare website. Everyone should start a conversation with family and physicians.
Advance care planning is the process of making decisions about the care you would want if you couldn’t speak for yourself. The goal is to decide, long before you are ill or frail, what would be meaningful to you.
Your decisions should be based on your personal values and preferences. Discuss your choices with your loved ones so they are aware of your wishes – even if they don’t agree with them.
The documents used in advance care planning are called advance directives. They fall into two categories:
1. Documents that provide instructions regarding your medical care
2. Documents designating a proxy, surrogate, or medical power of attorney to make decisions for you if you are unable to do so
What follows are tips promoted by VITAS Healthcare to get you thinking about what your wishes might be and how you will document them. Celebrating 40 years of caring for patients and their families near the end of life, with service areas throughout Florida and the nation, VITAS Healthcare staff are experts in end-of-life care.
How to complete advance directives
• You do not need a lawyer to prepare advance directives.
• Your advance directives should reflect your wishes.
• Get information on the types of life-sustaining treatments that are available and decide what treatments you would or would not want should you be unable to speak for yourself.
• Share your personal values and wishes with your loved ones.
• Document your wishes by putting this information into writing using Florida advance directives forms (or the forms of whichever state you live in).
• Read the instructions carefully. Include all necessary information and be sure documents are witnessed properly.
• Keep the original documents safe but accessible (not in a safe deposit box, for example). Your family will need to access them. Give copies to family and trusted friends. Note on their copies where the originals are kept.
• Provide a copy of your advance directives to your healthcare providers so they know your wishes and can make appropriate referrals to honor your choices.
Things to consider
• If you are in an accident or have an illness that leaves you unable to talk about your wishes, who will speak for you?
• Are there certain support measures you would or wouldn’t want if you were terminally ill?
Conversations that focus on your wishes and beliefs will relieve loved ones and healthcare providers of the need to guess or deal with conflicting opinions about what you would want.
Before your living will can guide medical decision making, two physicians must certify that you are unable to make medical decisions and that you are in the medical condition specified in your state’s living-will law. Other requirements may apply, depending on your state.
Before a medical power of attorney goes into effect, your physician must conclude that you are unable to make your own medical decisions. If you regain the ability to make decisions, your healthcare proxy or surrogate cannot continue to act on your behalf. Many states have additional requirements that apply only to decisions about life-sustaining medical treatments.
Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one. You should review your advance directives periodically to ensure they still reflect your wishes.
One state’s advance directive does not always work in another state. If you plan to spend a significant amount of time in more than one state, you should complete advance directives for each of those states. You can locate every state’s advance directives forms at CaringInfo.org.
For more information about end-of-life care, contact VITAS Healthcare at 866-759-6695 or visit VITAS.com.