Creating a healthcare directive: one conversation can make all the difference

We plan so many aspects of our lives. As young adults, thoughts of when and how we will complete our education, begin our first job, or buy our first home. Later, the focus may be on when and where to go on vacation, buy a vacation home or even retire.

Yet, we often don’t think about how we want to live. Advance Care Planning is a process of planning for future medical decisions. The process includes reflection on what is most important in our lives – hopes, dreams and aspirations to live life to its fullest potential now and at the end of life, values and beliefs (cultural, religious, spiritual, and personal).

As hard as it may be to think about the end of one’s life, the big question is, do your loved ones know your wishes for medical care if you can’t speak for yourself? Taking the time now to talk about what is most important and meaningful to you for your quality of life will ensure that your wishes are honored should you become unable to communicate them. It will also reduce the stress for your family and/or health care proxy if a sudden accident or illness occurs and they need to make healthcare decisions for you.

A health care directive is a written plan outlining your goals, values and priorities for your future medical treatment. Through your health care directive, you make your wishes known regarding future medical treatment to your loved ones, your health care team and your health care agent in the event you are unable to communicate.

Those who are seriously ill or have advanced frailty may also execute a POLST or Physician Order for Life Sustaining Treatment form. POLST forms must be filled out and signed by your health care provider. The POLST form tells other health care providers your wishes for future medical care and follows you wherever you go for care.

Generally, medical providers such as paramedics will automatically treat a person as full code status which means if a person’s heart has stopped beating or they have stopped breathing, all resuscitation procedures will be provided to keep them alive, unless a POLST has been completed and is available to the paramedics.

In the hope that fewer families will endure the stress of making health care decisions without knowing their loved one’s wishes, Benedictine seeks to encourage families to have thoughtful conversations and complete reliable advance directives. Benedictine has trained facilitators and tools to guide our residents and their families through these conversations.

No matter what your age, now is the time to have this conversation, because it always seems too early, until it’s too late.

Are you concerned about an elderly family member and don’t know how to start the conversation. Begin with yourself. Walk through the process for yourself. Document your priorities and wishes in a health care directive. Then talk about them with your family, friends and loved ones. It makes beginning the conversation with others easier.

For tips and tools, see the list of resources below.

• Go Wish gives you an easy, even entertaining way to talk about what is most important to you. The Go Wish cards help you find words to talk about what is important if you were to be living a life that may be shortened by serious illness. Learn more at www.Gowish.org.
• Honoring Choices Minnesota is a public health initiative of Twin Cities Medical Society through its Foundation. Honoring Choices Minnesota’s goal is to “spur family conversations about future health care preferences and to assisted health care organizations and community partners with the installation of a comprehensive advance care planning program.” Honoring Choices Minnesota’s website offers educational materials, videos, Advance Care Directive fillable forms for download (long and short versions) in English, Arabic, Chinese, Hmong, Russian, Spanish and Somoli languages, and a POLST form. Go to www.honoringchoices.org.
• Institute for Healthcare Improvement’s Conversation Project created National Healthcare Decisions Day (NHDD) to inspire, educate and empower the public and provides about the importance of advance care planning. NHDD is an initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be. State specific resources for advance care planning are available at www.theconversationproject.org/nhdd/advance-care-planning.
• National Institutes for Aging website explains the basics of advance care planning, advance care planning decisions, and how to start the conversation in easily understood directions. The site walks through how you can make your wishes known, how to choose your health care proxy, how you make your health care directives official including details on what to do have you complete your advance directive. Go to www.nia.nih.gov/health/advance-care-planning-health-care-directives.
• Many states have their own advance directive forms. Your local Area Agency on Aging can help you locate the right forms. You can find your area agency phone number by calling the Eldercare Locator toll-free at 1-800-677-1116 or by visiting www.eldercare.acl.gov.