Being prepared and having important documents in place can give you peace of mind, help ensure your wishes are honored and make it easier on your loved ones in the future.
Most of us don’t like to think about the end of life. We worry we’ll upset our loved ones by talking about it, so instead, we choose to stay focused on the present and ignore the “what ifs.” It’s true – it can be hard to talk about what would happen if you became ill or injured and could not make decisions for yourself. But as hard as it may seem, it’s an important process.
Advance care planning allows you to think about those future health care questions ahead of time and make it easier on your family and friends in the future. Learn what advance care planning is, how to begin the process and what resources are available to help.
What Is Advance Care Planning?
According to the Department of Veterans Affairs (VA), advance care planning is the process of identifying your values and wishes for your health care at a future time if you are no longer capable of making choices for yourself.
In other words, advance care planning involves deciding what treatments you would or would not want if you were ill or injured. It also involves choosing a person to make those decisions for you if you’re incapable of doing so yourself. Legally, this can be done by completing an advance directive.
What Is an Advance Directive?
Many people incorrectly assume their family members will automatically be able to make decisions for them about medical treatments, but that’s not always the case as rules can vary greatly from state to state. Many people also assume their surviving family members will all agree on the best path forward, but that’s not always true either. Having an advance directive ensures that your voice will be heard.
An advance directive is a legal form that reflects your future medical or mental health care wishes. It can help your doctors and loved ones make informed decisions about treatments if you can’t decide for yourself.
The advance directive used by VA includes two components:
- Living will – This document details the health care treatments you would and would not want, such as a feeding tube, a breathing machine, resuscitation, and more.
- Durable power of attorney for health care – This allows you to identify a health care agent or a person to make health care decisions for you if you’re unable to make them for yourself.
VA honors all types of legal advance directives, including forms from other states, the Department of Defense or VA.
How Do I Get Started?
Although the advance directive is a straight-forward form, there are some things to consider as you begin the advance care planning process:
Think about the medical treatments and care you would or would not want in the future. This includes thinking about difficult topics like – Do I want to be kept alive if I’ve suffered severe brain damage? Do I want to use a feeding tube if I can no longer take care of myself? Are there treatments that may interfere with my cultural or religious beliefs?
- To help you answer these questions, VA offers a values worksheet full of thoughtful questions. Questions like – How important is independence to your way of life? How important is it to be able to relate to family and friends? Do you want to live as long as possible, no matter the quality or state of living?
- You may want to discuss these topics with your health care team. They may be able to help you weigh the pros and cons of different treatments, help you think through likely situations and more.
- Consider the person you’d like to name as your health care agent. This list might include your spouse, an adult child, another family member, a friend or a neighbor. To help you pick the right person, consider:
- What person in your life shares your views and values? Who do you feel comfortable discussing your wishes with? Who would you want talking to health care providers if you’re unable to? Who do you trust?
- Your health care agent should be willing to follow your wishes and advocate for the care you want, even if he or she doesn’t agree with it.
- You may want to consider more than one person, in case the first person you choose is not able to fill the role.
- VA offers additional resources and ideas for helping you choose your health care agent.
Talk to your health care agent. Once you’ve made the decision, be sure to talk with this person about your values, wishes and choices. Make sure this person is “on board” and ready to take on the role.- Talk to your loved ones. It can be hard to discuss end-of-life choices and decisions with the people you love, but it’s an important step in the advance care planning process.
- VA offers tips for talking to your loved ones, including piggybacking on a life event to open the conversation, like a recent hospital visit or a memorial service for a friend.
- VA also recommends the PREPARE Program, an interactive program that can help you identify your values, how to talk to your loved ones and more.
What Do I Do After I Fill Out My Advance Directive?
- Make copies. Give a copy to your health care provider, your health care agent and another family member for safekeeping.
- Put the original in a safe and easy-to-access place. Your advance directive should go in a file along with other important documents. You may want to consider using a fireproof or waterproof box for even more security. Be sure your health care agent knows where the original is kept.
- Review it regularly. Advance directives don’t expire, but you can change yours at any time. You may have a change in your life, such as a divorce, a change in your health care agent, or you may have changed your mind on different medical treatments that have come into use. Reviewing the document once a year ensures it reflects your most up-to-date wishes.
- Consider additional health care-related issues as you plan for the future.
- VA offers resources for setting other health care goals that include looking at palliative care and hospice care.
- VA also offers additional information on other types of advance care planning that you may be interested in, such as a Do Not Resuscitate order and organ and tissue donation.
Resources
- VA’s Geriatric and Extended Care page offers information on all of the topics covered in this article, including links to more resources, such as helpful websites, forms and workbooks.
- VA offers a group visit program for Veterans, caregivers and those they trust to help with advance care planning. The program facilitates a group discussion that encourages participants to identify the next steps to take in the planning process.
- The National Institute on Aging provides a Getting Your Affairs in Order Checklist: Documents to Prepare for the Future, which discusses important documents and decisions that go beyond your medical care, including making a will, establishing a durable power of attorney for your finances, creating a living trust and more.
- The National Institute on Aging also has articles related to choosing a health care agent and preparing a living will, including a free Conversation Guide which provides worksheets, conversation guides and other tools to help you prepare and plan.
Being prepared and having important documents in place can give you peace of mind, help ensure your wishes are honored and make it easier on your loved ones in the future.