Advance Care Planning
What is Advance Care Planning?
Advance Care Planning isn't just for people who are getting older. It is important for all adults to plan for future medical needs now because a serious accident or illness can happen at any age. Anyone over 18 years of age can and should complete an Advance Directive. Conversations about Advance Care Planning should be part of routine medical care because anyone can fall victim to a serious illness or injury. Completing an Advance Directive becomes even more important for people with serious medical conditions, and for people with advanced illness or those at higher risk of losing their decision-making ability, Advance Care Planning becomes a critical need. Advance Care Planning helps adults at any age or stage of health understand and share their personal values, life goals, and preferences regarding future medical care. It is a gift you give your loved ones who might otherwise struggle during a medical emergency to make choices about your care. Advance Care Planning is not a single decision; it is a process that occurs over a lifetime as goals and values change.
Steps in the Advance Care Planning Process
1. Thinking about your wishes for future care
If you became seriously ill or seriously injured, what would you want done medically? Your wishes may be shaped by your experiences, cultural & religious views, your values, and your goals. If you need help or care, who will provide that for you, where do you want to receive care, and who will pay for those services?
2. Selecting a health care representative
When selecting a health care representative, the following qualities are important to remember:
●Is the person willing to accept this role and responsibility?
●Is the person willing to have conversations with you about this topic?
●Do they know what you would want for future medical care?
●Would they advocate and make decisions you would want them to make, even if they disagree with the decisions?
●Would they be able to make difficult medical decisions under stressful conditions?
●Note: a healthcare representative can be anyone you trust to make these decisions. They do not have to be a family member and they can live anywhere. They do not have to live locally.
3. Discussing your wishes with your health care agent and other loved ones
This step is sometimes difficult, but it is a very important, and may help you avoid future conflicts. It is important to have ongoing conversations about this subject with your health care representative(s), so they better understand your current wishes and preferences. It is also wise to communicate openly with family, especially with those relatives who are closest to you. It is best they get the information directly from you and not from a document or other family member. This communication is ideal to prevent or avoid conflicts about your care.
4. Completing formal documents
Important forms that are part of Advance Care Planning include:
●Advance Directive
●POLST or Portable Order for Life-Sustaining Treatment form
●Durable Financial Power of Attorney
5. Making and sharing copies
●Provide copies of your Advance Directive (and POLST if appropriate) to your health care representative(s).
●Provide copies of your durable financial power of attorney to the person(s) listed as your agent(s).
●Provide copies of your Last Will and Testament to the individual you listed as Executor.
●Provide copies of you trust to those listed as co-trustees.
NOTE: We also ask that as you complete these documents, that you have them scanned into your medical record here at Republic County Hospital. These documents will allow those caring for you to know and understand your wishes, as well as those you have given legal authority to act on your behalf should you be unable to do so. These documents will also allow our staff to contact the appropriate individual(s) for your care.
6. Periodically reviewing your Advance Care Planning documents
These forms are not a "one and done" process. It is best to review these documents periodically to make certain they remain up to date and current. The following are suggested:
●Every 3-5 years to determine if your goal, values, and preferences remain the same.
●If you have been hospitalized.
●If your health condition has changed. If you are diagnosed with a serious or chronic, progressive illness at any age, talk with your primary care provider about your treatment goals. If your goals include a preference for less aggressive treatment based on your current health condition, then completing a POLST form might be appropriate. The goal of Advance Care Planning is to ensure that your treatment wishes are known and honored.
●If there are changes to the demographic information for you or your health care representative(s), be sure names and contact information are updated.
●Ideally, Advance Care Planning begins in early adulthood with the completion of an Advance Directive and the naming of a health care agent. Your Advance Directive should then be reviewed and updated periodically throughout your life.
Who Can I Talk with About Advance Care Planning?
Karla Awalt is the Social Services Manager at Republic County Hospital. She is also a Certified Advance Care Planning Facilitator. If you would like to schedule an appointment with Karla to discuss any of these issues for you or a family member, you may contact her at 785-527-9171.