Advance Care Planning

When it comes to health care today, choice plays an incredibly important role. This is particularly true when dealing with end-of-life care and situations in which mental and physical deterioration can hamper an individual’s ability to express their preferences.

Advance care planning, otherwise referred to as ACP, isn’t just something that the elderly need to concern themselves with. While it serves a strong purpose for that population, it is also important for all individuals to whom accidents or illnesses can happen (which means everyone!).

This form of document care aims to help adults at any stage of life and in any stage of health understand what their personal values are, take stock of their life goals and dictate their own preferences for future care. It is not one choice or decision, but rather an accumulation of decisions that align with a lifetime of goals and values, and one that can morph and evolve as life changes. It’s better to think of ACP as a process that includes:

  • Thinking Ahead
    Consider if you were to suddenly become seriously ill, what would you like in regards to your future care? Think about your experiences, religious or cultural views as well as your values and goals.
  • Selecting an Agent
    Whom do you trust enough to make decisions for you if you are incapacitated and no longer able to do so for yourself? Appointing a health care agent means assigning a loved one to make medical choices on your behalf.
  • Discussing Wishes
    While a difficult topic, sitting down for a heartfelt and honest conversation with your health care agent is an important part of preventing future conflict and conveying clear boundaries.
  • ACP Documents
    Often Advance Care Planning documents are referred to as Advance Directives. This paperwork explicitly states your wishes. In addition to ACP documents, your health care provider may also desire that you complete other forms like a Physician Order or a Life-Sustaining Treatment (POLST) form for your medical files.
  • Make Copies
    Once you complete your paperwork, you’ll want to share it with your health care agent, your primary care doctor and lastly, place a copy in your medical records.
  • Revise as Necessary
    Throughout life, you’ll want to revisit your ACP to review your wishes and ensure that your plan hasn’t changed. If it has, revise your forms and redistribute to your team.

Focusing on the Future

It is important to note that medical care practices are always changing and improving with new technologies and medicines. These types of important advancements enable medical professionals to treat more conditions and developing diseases. At the same time, many of these medical advancements fall outside the desire of care for patients. ACP goals focus on the future to ensure that care remains in line with a patient’s goals.

For the medical community, it’s important to understand people’s health goals in order to find the right course of treatment. When a patient is unable to speak for themselves or when a health care agent or other loved one is speaking on their behalf, an ACP allows the speaker to confidently relay information about treatment choices. Most forms focus less on specific treatments, since it’s not really about the treatment, it’s more about a person’s values and goals for living.

Tips for Completing an Advance Directive

Any individual over the age of 18 can and should complete an Advance Directive, particularly any individual with medical conditions or for those suffering with an advanced illness that impacts their decision-making abilities.

Questions to help prepare and complete this type of paperwork include:

  • If you could plan ahead, what would you like the last week of your life to look like?
    • Who would you like to keep you company?
    • What location would you like to be in?
  • Describe your ideas and hopes about the future and the end of your life.
    • What are your main fears and concerns?
  • Do you have a type of care preference if you are suffering from a severe illness?
  • If you have your choice, where would you like to spend your last days?
    • At home? Or in the hospital?
  • Is there someone who you’d like to make medical decisions for you if you are unable to do so?
  • Do you want your life to be preserved for as long as possible or are there types of mental and physical conditions that you think should not be used?
    • For example, if you are unable to notice your surroundings, unable to continue important relationships, unable to make everyday decisions, or in severe pain or discomfort?
  • Do you have any explicit wishes for funeral planning?

Goals of ACP

One of the main goals of this type of advance care planning and ensuing discussions is to ensure that medical and clinical care received is consistent and in line with a person’s expressed preferences and care wishes. Additionally, this form of planning may allay anxiety, depression, and post-traumatic stress for loved ones and family members assuming care.

Beyond creating a framework of information for choices, the process around ACP may prevent unwanted medical intervention and measures, particularly for those near the end of life. By addressing difficult topics such as CPR, artificial ventilation and artificially administered nutrition and hydration measures, in addition to added risks and benefits of these medical procedures, the entire process can address items such as hospitalization, chemotherapy, dialysis, antibiotic therapy or other invasive actions.

At Wings of Hope, we know deeply that brief, periodic conversation on the matter may be more beneficial and easier to approach than a one-time discussion. Whether a loved one is facing an acute illness, a long-term chronic disease or a different scenario, advance care planning is important in upholding quality of life and living standards. Other benefits of the process include less aggressive medical measures that often contribute to a higher quality of life near death.

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