Planning ahead: Advance directives

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Article written by Madison Evans, MSW, SWLC
KRH Cancer Support & Survivorship - krh.org/cancersupport
 

What is advance care planning and who needs it?

It is not unusual to avoid conversations about the end of life. So, it is normal that most of us don’t discuss or truly understand what advance care planning is. But what if you learned that you have a life-threatening illness or are nearing the end of your life? Would you know where to start or what to think about? What are your medical wishes? Are you an organ donor? Who is in charge if you cannot answer these questions for yourself?

Advance care planning means you complete an advance directive that tells your doctors and loved ones what medical care you want to receive in the event you are not able to communicate for yourself. This also includes designating a person who will communicate and follow through with the decisions you have made.

Advance care planning includes two main documents and many important conversations. 

1. Your living will: A living will document informs your loved ones and health care team what medical treatment you want to receive if you are unable to convey your wishes. Without a living will, the laws in your state will determine who will make your health care decisions.
2. Medical power of attorney: A medical power of attorney document allows you to designate one person who knows your wishes and will make sure the medical team understands it and follows through with it. The person you choose to be your medical power of attorney needs to be someone you trust and who feels comfortable carrying out your plans.

Conversations about these documents may be the most important part of this process. The decisions you are making in advance care planning are not ones to make on a whim. It will take introspection and time. Time to think it through and talk with other loved ones, to come to a decision that is unique to you and your personal values. Then, be sure to discuss the details with the person you selected as your medical power of attorney so they truly understand why you have chosen the options you have in your living will. This is not a secret and should not be treated as one.

The ideal time to create advance directives 

Creating your advance care directive [ie. living will and medical power of attorney] should include careful planning. But most importantly, it does not have to be done late in life. The best time to put this very critical information on paper is now. Everyone, including those from age 20 to 70+, is strongly advised to create an advance care directive. If you are a healthy, fit person in your 20s you may find advance care planning is straight forward — perhaps with a request to perform all medical treatments possible in event of a life-threatening medical situation. Or perhaps a person wiser in years, such as an 80-year-old facing a lifelong illness, may request less drastic measures in the same situation. No matter the details, it’s your choice.

Advance care planning is important at all stages in your life so if an unexpected event occurs your loved ones and health care team has clear instructions on what medical treatments you want. Putting these plans in place relieves your family and loved ones from the stress of decision-making in an already trying and difficult time. Consider doing this as a favor to your parents, partner, children and those that care about you.

Inform your loved ones and health care providers

Finally, be sure to share your desires with those you trust well in advance. Also remember that as your life changes, your wishes may adjust. It’s a good idea to review your plans from time to time as your life changes along with technology and science. These are living documents that can be updated as many times as you see fit. It’s a great idea to keep a copy on record with your local hospital and primary medical clinic as well. So remember, regardless of your age and health status, it is important to complete an advance care directive that matches your personal values.

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