Advance Care Planning: What It Is and Why It Matters

What is advance care planning – and why should I do it?

It’s the process of reflection and discussion to help you clarify what your wishes are for the end of your life. It’s not just a healthcare directive – although that is potentially part of the process – but it’s thinking through what’s important to you at the end of your life. A healthcare directive is putting those wishes into writing – it answers some of those critical end-of-life questions that you would then provide to your family and your physician. Going through the process of advance care planning can help you determine what you want for yourself, and it’s also really a gift to loved ones – it helps lessen the burden in a crisis and it lets them know what you’d want so they don’t have to make those decisions for you.

What does a healthcare directive entail?

A healthcare directive is a legal document that lets your loved ones and your physician know about your healthcare preferences. It answers questions about whether you’d like to be revived if necessary, and what kind of treatments you’d like in the event you aren’t able to communicate your wishes for yourself. You can get help filling out your healthcare directive from a social worker or a chaplain while you are in one of our hospitals. Additionally, all North Memorial Health clinics have care coordinators who can help patients and family members with advance care planning.

What are the main questions I should be thinking about when it comes to planning for unexpected medical events?

The three biggest questions to think about are:

• Who would you want to make healthcare decisions for you if you couldn’t make them yourself?
• Would you want CPR if your heart stopped?
• What would be the goals of treatment if you permanently lost the ability to meaningfully know who you were, who you were with, or where you were?

You also want to think about whether you’d like to have life-prolonging treatments such as being put on a ventilator, feeding tube, or dialysis. Filling out a healthcare directive that specifically answers these questions and designating a healthcare agent will help medical professionals know how to provide the type of care you want in various scenarios.

Who should I appoint to be my healthcare agent?

We recommend you think through that very carefully, because whoever you choose as your healthcare agent will be called upon when you are having a healthcare crisis. They will be discussing your wishes and your care with social workers and physicians, and they’ll need to be able to set aside their own wishes and speak to the medical team about your treatment preferences. Some of the qualities you might want to look for when choosing a healthcare agent are:

• Someone who knows you and your health conditions
• Can make decisions in a crisis
• Will honor your wishes
• Can stand up to family members who may disagree with your wishes
• Is likely to be available during a health care crisis

We encourage people to pick someone who’s going to be available in the moment you need them. For example, if you have a son or daughter who doesn’t live near you or travels frequently, that might not be the best person. Also, you need to sit down and have a conversation with them. We’ve had some people who have asked their religious or spiritual leader, which is totally fine, but they need to know. We’ve had to call people who had no idea they were designated as someone’s healthcare agent.

What should I do with my completed healthcare directive?

Once you’ve completed your healthcare directive, you should give a copy of it to your healthcare agent, family members, your primary care physician and primary hospital. And you’ll want to keep the original where it can be easily found. When a person completes a healthcare directive in the hospital, we will scan it into their medical record. But that only stays within the hospital system, so you’ll want to make sure your loved ones have a copy in case something happens and you’re outside of the system.

When should I start thinking about advance care planning?

We recommend anybody over the age of 18 complete a healthcare directive. People often spend years thinking about what their wishes are before they’re ready to put it down in writing. It’s hard for people to think about it when they’re not in a medical setting – and many people don’t think about it until they come to the hospital. But the best time is not when you’re in the hospital in a medical crisis. There was suddenly a lot more interest in advance care planning when COVID hit. People realized that they could end up on a ventilator. I think it opened people’s eyes that we don’t know what might be the next major public health crisis – or when their own personal health crisis could come.

Can I revise my healthcare directive?

Yes, in fact, we recommend you revisit your healthcare directive every year at your annual physical. It’s also a good idea to review it every Decade, or when you or your healthcare agent experiences a Death, Divorce, Diagnosis or Decline in health.

Where can I get a healthcare directive form?

We recommend you consider filling out one of the forms available at Light the Legacy. They are available in multiple languages and come in long or short form versions. You can fill one out here.

What are some other resources on advance care planning?

A great resource we recommend is The Conversation Project. You can find more information about advance care planning through North Memorial Health and the resources we offer here. You can also call our Advance Care Planning hotline at 763-581-8282.