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.
Who Can I Talk with About Advance Care Planning?
Karla Awalt (Social Services) is the social worker and also a Certified Advance Care Planning Facilitator for Republic County Hospital. If you would like to schedule an appointment with Karla to discuss any of these issues for you or a family member, call 785-527-9171.
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 and 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:
●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) to best plan 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) to be sure names, 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.
Advance Care Planning Documents
1. Advance Directive
●a legal document that allows you to name a person(s) (Health Care Representative) to make health care decisions for you if you cannot make them for yourself.
●It allows you to write down your goals, values, and preferences so that your health care representative and health care providers have your expressed wishes, in a legally binding document, should you be unable to verbalize them yourself.
●It is for adults 18 years and older, regardless health condition.
2. Portable Orders for Life Sustaining Treatment (POLST)
●A POLST is not for everyone. The POLST form is designed for people who have chronic health conditions and/or those who are seriously ill or medically frail. A POLST is most useful for people who want less than fully aggressive medical treatment in their current health state.
●The POLST states the types of treatments you want or do not want when you are very sick or frail.
●It gives you more say over the medical treatment you get in an emergency.
●It guides medical treatment if you cannot say what treatments you want.
3. Durable Financial Power of Attorney
●This is a legal document in which you delegate to another (your 'agent' or 'attorney-in-fact') the authority to deal with your finances and assets. Usually, a Power of Attorney becomes effective when you sign it, although you may indicate that it is not to be used unless you ask your agent to use it, or unless you become incapacitated.
●Even if you are legally married, you and your spouse do not have legal authority to speak on behalf or manage each other's affairs, unless given legal authority. Some examples would be insurance policies or assets in your spouse's name only such as Social Security, Medicare, Medicaid or other government benefits, health insurance, retirement accounts or pensions, etc. Many believe that a beneficiary has legal authority to act on a person's behalf, however that is not true. A beneficiary is a term used for an individual who will receive an asset upon an individual's death.
●Note: Naming a power of attorney for health care is different from naming a financial or fiduciary power of attorney (someone who manages your finances). The two require different processes and forms.