Making your end-of-life plans may be a gloomy task, but it could be the most generous gift you ever give your loved ones.
That’s because advance care planning relieves them of the burden of making tough decisions regarding your health if you become unable to speak for yourself. Spelling out exactly what you want concerning your medical care, and then choosing someone to speak on your behalf, helps your loved ones feel confident they’re carrying out your wishes.
“Advance care planning addresses situations the patient could potentially encounter so that nothing is a surprise to the patient or the family,” says Regina Reed, manager of the care coordination department at University Hospital.
What is advance care planning?
Advance care planning involves multiple aspects, including advance directives and medical power of attorney. These are legally binding documents that you must sign with witnesses or a notary public.
- Advance directives, such as a living will, outline exactly what treatment you want—or don’t want—should you not be able to make those decisions in the moment. Types of advance directives include life-sustaining treatments such as CPR, tube feeding, a ventilator, a blood transfusion or dialysis. These can be accepted or refused. Those decisions will be written into your advance directives before you encounter those situations.
- Your medical power of attorney is the person you designate to carry out your wishes if you can’t speak for yourself. If you become incapacitated, this person will have the same authority to make medical decisions for you as you would have yourself.
When to set up advance directives and medical power of attorney?
If a patient comes into the hospital and doesn’t have advance directives or a designated medical power of attorney, he or she will have the chance to sign those forms. And while it’s always good to get the documents in order at any time, those decisions are often easier to handle emotionally when they are made separately from an imminent diagnosis, says Tim Gonzales, the director of senior services at University Health System.
“If a person gets a diagnosis and we immediately offer advance care planning, they think they’re going to die,” Gonzales says. “Instead what we try to do is tie it to a wellness visit, just like they get a prostate exam or colonoscopy when they reach a certain age.”
Similarly, when you need to designate someone to carry out your wishes through a medical power of attorney, it’s easier to discuss the topic before any serious health problems occur.
“When there’s a diagnosis and you have to designate a person, the kids have a hard time with that,” Gonzales says. “It’s better to bring up the conversation when it’s not tied to a recent visit when you got bad news. It’s better to bring it up when it’s just a point of conversation.”
Reed advises making sure the person you choose knows your wishes and is willing and able to honor them. She said there’s rarely a time when the entire family is in agreement on how to proceed with life-sustaining treatment. Having advance directives and medical power of attorney can help prevent disputes about what to do.
Adults of any age—even healthy people—can have advance directives and someone to act as medical power of attorney. University Hospital helps make the process of advance care planning as easy as possible, either as an inpatient or before a hospital stay. Social workers, nurse case managers and others will work with patients and their families to help them feel more comfortable discussing end-of-life decisions.
The legal documents for advance directives and medical power of attorney vary by state. Download the forms that comply with Texas law here: