Don’t lock your health care directives in a safe! Here’s what to do instead.
Advance care planning refers to the documents AND conversations about your health care wishes and values, giving direction to loved ones and your medical team when needed. It’s often seen as something to check off your list, file your paperwork away, and push out of your mind to make room for seemingly more important things–like next month’s weekend getaway or what appetizer you’re going to take to Mahjong tomorrow night. But wait–it’s anything but!
Your wishes and values may change as your health changes and as you age. Advance care planning is a process, an ongoing conversation, and should be revisited often during your life. Here’s what to do once you’ve completed your documents:
- Have the conversation and share your documents! Make sure to provide a copy to your designated decision maker, any alternate decision makers, and any doctors you routinely see, like your primary care doctor, cardiologist or oncologist.
- Keep digital and physical copies easily accessible. If you can, keep more than one physical copy and save any documents in separate PDFs so you can easily email them to medical providers. Keep each document separate to prevent confusion if you change one document but not another down the road. Keep track of how many documents you give out and to whom so that you can provide update documents in the event of a change later.
- Review your advance directives often and use the framework below:
The “5 Ds of Advance Care Planning”
–Decade: Getting older often causes us to pause and think about the years behind us and the ones ahead. Have your wishes and values changed in the last 10 years?
-Death of a Family Member or Friend: Loved ones are often more open to conversations about your wishes when the opportunity presents itself organically. Take the time to review if you need to add or take off a health care agent, especially if someone listed on your directive is now deceased.
–New Diagnosis: Receiving a new diagnosis may change what’s feasible for your care as your health changes. It may also change the level of care your loved ones would reasonably be able to provide for you.
–Destination: Different states use different versions of forms, and some states have different rules to ensure your documentation is legal. Always review your documents when moving to another state to ensure your wishes can be honored.
If you or a loved one is moving to a different care facility in the same state, always check to ensure the new location has all of your documents and will honor them. Despite state laws to ensure that documents are honored as someone moves (i.e. the MOST or Do Not Resuscitate form), care facilities do have some agency to make more restrictive rules.
–Decline in Health: Similar to when receiving a new diagnosis, your perspective and what’s important to you may change as your health declines. Are there new challenges you need to consider? What other information do you need about what you can expect as you decline to make any needed updates to you directives?
Looking for some support and guidance in making some updates to your documents, or talking through some new questions or hesitations? Reach out about individual or family Advance Health Care Planning Counseling.