Planning for the future? Advance care directives offer peace of mind

Planning for the future? Advance care directives offer peace of mind
advance care directive

advance care directive

Death. It’s inevitable. Most people dread talking about it.

Unfortunately, medical emergencies and untimely deaths do occur, so families need to plan for end-of-life care.

To ensure medical care matches a patient’s values, many families establish advance care directives. According to the American Medical Association, “Advance care planning affords patients the opportunity to exercise their right to make determinations regarding their medical care in advance in the event they become incapable of active participation in health care decisions.”

Don Schumacher, president and CEO of the National Hospice and Palliative Care Organization (NHPCO) in Alexandria, Va., says family members often second-guess their decisions when end-of-life care isn’t discussed in advance. “I’ve seen a lot of families torn apart because they’ve not been able to agree on what the person wanted.”

State laws for advance care directives vary, so you need to be aware of the requirements in your state. The laws typically govern who can be a witness, if the advance directive requires notarization and even whether a pregnant patient can refuse or stop life-prolonging care. Also, be aware that not all states honor out-of-state directives, so if you live in more than one state, prepare a directive for each state.

Use the following tips to establish an advance care directive:

Pick a caregiver. Decide who you want to be your health care proxy or representative and discuss your wishes with that person.

“Choose someone who is comfortable making the decisions you want made,” says Syracuse University College of Law professor Nina A. Kohn. “I recommend that when an individual is choosing a surrogate decision maker that they consider that person’s values.”

Things to consider include life-sustaining treatment, pain management and organ donation, says Robyn Shapiro, an attorney specializing in health care law with Drinker Biddle & Reath in Milwaukee. “You should think about how you value quantity of life versus quality of life,” he says.

Fill out your state form. Forms are available through local health departments, hospitals, nursing homes and websites for non-profit organizations such as NHPCO.

Kohn says you want your document to give clear advice, but not be too restrictive. Advance care directives can’t detail every possible situation and should give the health care proxy some flexibility. “If you’re spelling out your wishes in extreme detail, you may be binding your agent to act in a way that you wouldn’t want them to act,” Kohn adds.

Revisit your advance directive. Kohn recommends revisiting your advance care directive every three years to make changes as needed. You can change your proxy as well.

Think about safe storage. Like all important documents, keep your advance care directive in a safe place. Let others know where to find the original document, and make several copies.

Start to plan now. All experts agree everyone over 18 should have an advance care directive.


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