Put It in Writing with Advance Care Planning
If something should happen to you and you were unable to communicate with your healthcare providers and your family, how would you ensure you receive the care you want? As medical professionals, a patient’s agency — that is, their ability to consent and make decisions for themselves — plays an important role in the delivery of services. However, severe injuries and debilitating illnesses can sometimes prevent patients from verbalizing their wishes.
April 16 is National Healthcare Decisions Day, an opportunity for healthcare professionals to spread awareness on the importance of advance care planning. Learn more about creating invaluable directions for your providers and your family and how you can help guarantee you receive the type of care you want.
What Is Advance Care Planning?
According to the National Institutes of Health, advance care planning describes the process of discussing or preparing for medical decisions should you fall seriously ill and lack the ability to communicate your healthcare wishes. This means discussing your preferences with your family or a close friend in addition to creating advance directives, or legal documents, that detail instructions for your care. These directives only go into effect when a medical professional has confirmed you are unable to communicate your wishes. The State of Illinois allows four types of advance care planning:
- Healthcare power of attorney — Your power of attorney is a designated healthcare proxy (usually a family member or close friend) who can legally make medical decisions on your behalf.
- Living will — A living will is a set of instructions for your healthcare provider that explains in writing the types of medical treatment you want and the types you’d prefer to avoid. For example, if you wish to avoid being put on a ventilator, you may communicate these wishes in your living will.
- Mental health treatment preference declaration — This document allows you to decide if you receive certain mental health treatments such as electroconvulsive treatment (ECT) or psychotropic medicine when you have a mental illness and are unable to make these decisions yourself.
- Practitioner orders for life-sustaining treatment (POLST) — A POLST order instructs healthcare providers on the use of CPR and other life-sustaining procedures.
When to Make an Advance Care Plan
Some may regard advance care planning as something that can be done later, or something that should only be done after receiving a terminal diagnosis. Unfortunately, an accident or medical emergency can strike at any time. Though you can’t predict where or when, you can prepare by creating advance care directives as soon as possible.
In the event you don’t have an advance care plan and are unable to communicate with your providers, a healthcare surrogate may be chosen for you. Once two doctors confirm you are unable to make your own decisions, a surrogate will be contacted by the provider as detailed in Sec. 25 of the Health Care Surrogate Act. A healthcare surrogate may be (in order of priority):
- Legal guardian
- Spouse
- Adult child or children
- Either parent
- Adult brother or sister
- Adult grandchild or grandchildren
- Close friend
- Guardian of the estate
Your surrogate may not tell providers to withdraw or withhold life-sustaining treatments unless you have a qualifying condition as described by state law, including:
- A terminal condition with no reasonable prospect for cure or recovery and for which life-sustaining procedures would only prolong the process of dying
- Permanent unconsciousness with no thought, social interaction, or sensory awareness
- An incurable or irreversible condition with no prospect for cure or recovery that causes severe pain and for which life-sustaining treatment would have minimal impact
Steps to Planning Ahead
First, reflect on your own personal values and think about the kind of treatment you would want to receive at the end of your life. Communicate these values with your primary care provider and discuss your health to better understand which health decisions are likely upcoming. Advance care planning is covered by Medicare as part of your Annual Wellness Visit. Additionally, you should communicate your wishes with your private insurance provider.
Choose someone you can trust to act as your proxy. Discuss your values and wishes with them and communicate specific treatments and care decisions if you’re ready to; if not, talk about your general healthcare preferences. Finally, complete the necessary advance directive forms and share copies with your proxy, healthcare providers, and loved ones. Store the original copy in a safe, secure place.