Whether you’re living on your own or in an assisted living community, you probably still live an independent life and can make decisions for yourself. But maybe you’re worried about the future—” What if there comes a time when I’m not able to make my own decisions about my health?” Advance care planning can empower you to keep making your own decisions, even if you become unable to verbalize them in the moment.
What Advance Care Planning Is
Advance care planning is creating a plan about your future medical decisions in case you ever become unable to make these decisions for yourself. If you get into an accident or fall very ill and become unresponsive, for example, your advance care planning tells your doctors and loved ones what decisions you want to make regarding your health.
Advance care planning involves talking with your loved ones about what you want for the future, and you might want to put your wants in writing to create legal documents called advance directives. This way, your healthcare providers can take your wishes into account, even if you can’t express them in the moment.
What are Advance Directives?
Advance directives are legal documents that list your medical choices. These decisions are effective if you become unable to communicate your wishes yourself.
The first document that can be used as an advance directive is a living will. A living will tells doctors what medical decisions you want in case you are unable to communicate your decisions on your own. You can make note of what kinds of treatments you do and do not want, and under which circumstances.
Durable Power of Attorney
The second kind of document that can be an advance directive is called a durable power of attorney for health care. This document names your health care proxy, who is a person you chose to make health care choices on your behalf if you can’t do so yourself. Be sure to talk with your proxy about your wishes regarding your health in case of an emergency.
Advance directives are helpful documents that let your doctors know your medical preferences if your health declines. Keep in mind that while these documents are legally recognized, they are not legally binding. This means that while your doctor needs to consider your preferences listed on your directives, they are not necessarily required to follow them if the situation makes it difficult or impossible for them to do so. For example, you might be in a complicated medical situation that you did not list your preferences for, or your doctor’s professional opinion might not align with your decision. However, having all of your wishes laid out as clearly as possible can guide your healthcare providers in the direction you want.
Other Important Documents
Do Not Resuscitate Order (DNR)
A DNR is not an advance directive, but it may still be important to have depending on your wishes. By default, medical professionals are required to perform CPR on you to keep you alive if need be. Some people who are particularly old or terminally ill, however, may choose to not be resuscitated in these situations. Mentioning this in your living will is not enough—you need to fill out a DNR. A DNR is a medical order that requires a physician’s sign-off, making it legally binding. If you think you would want to decline resuscitation, speak with your doctor to learn about what steps to take next.
Medical Orders for Life-Sustaining Treatment (MOLST)
A MOLST is a New York-only form to fill out if you do not want to receive life-sustaining treatment. This differs from a DNR in that a DNR only prevents you from receiving CPR if your heart stops beating or if you stop breathing. A MOLST, however, declines any other kind of treatment that keeps you alive, such as life support. Like a DNR, a MOLST needs to be completed rather than just mentioning your preferences in your living will and requires a physician’s sign-off. Talk to your doctor about completing a MOLST if you think it’s right for you.
Why should I do Advance Care Planning?
If you do not have any advance directives, state laws will determine who gets to make decisions regarding your health if you cannot. In New York, your spouse will make these decisions on your behalf. If you are not legally married and do not have a partner listed as a healthcare proxy, any adult children you have will be responsible for these decisions. Otherwise, your parents will make decisions, and if they are not around, your adult siblings will. If you do not have any family, a close friend might have to make a choice for you.
If you do not have a living will or a clearly-identified healthcare proxy, your family could run into some legal issues. If, for example, you have multiple children and they disagree with what to do about your health, not only can this put extra emotional strain on your family, but it can become an expensive legal matter and lead to something called arbitration. Without clear guidance, you not only run the risk of losing autonomy over your own health, but also of creating extra personal and legal trouble for your family. To avoid this conflict, clarifying your wishes in a living will and/or naming a single healthcare proxy to make decisions on your behalf is crucial.
How do I Create Advance Directives?
You can create your advance directives at little or no cost. The first step is deciding who you want your healthcare care proxy to be. It can be your spouse, a family member, or even your lawyer. Whoever you choose, it should be someone you can trust and who knows your values. It’s a good idea to talk with your doctor about additional things to keep in mind when writing your living will or durable power of attorney.
To get started, you can contact your lawyer for help (although a lawyer is not required to create these forms), contact your State Attorney General’s office, or download the forms from the American Bar Association, AARP, or National Hospice and Palliative Care Organization’s websites. Give copies of your forms to your proxy or proxies and your healthcare providers, and be sure to carry a copy of your own as well. If you need help looking for resources for advance care planning, contact me, Teres Rodney at firstname.lastname@example.org. I can point you in the right direction for planning for the future so that you can have your wishes heard, no matter what comes up.