7 steps to advance care planning for peace of mind

During the course of a lifetime, you’ll need to have some difficult conversations with family members. Say, for example, talking about the birds and bees with your kids. A more somber conversation is the one when you need to convey what you want if you become incapacitated and unable to speak for yourself.

Advance care planning allows you to receive the medical care you want, even if loved ones have to make decisions on your behalf. Through a clear set of instructions, your family and medical professionals will know what to do if you face a medical crisis.

There’s a good chance that you or someone you know could benefit from advance care planning. In fact, about 25 percent of Americans will have to make such decisions but aren’t able to communicate to family or doctors.

Follow these seven steps to create an advance care plan to ensure that your wishes will be followed:

• 1. Review your medical history. Figure out what decisions you or your family might possibly have to make because of your medical conditions. Also consider your family medical history. For example, if you or family members have high blood pressure, you may need to think about decisions related to stroke.

  2. Consult your doctors about medical care scenarios. With your doctor, review different medical care scenarios, such as whether to use cardiopulmonary resuscitation, ventilators, artificial nutrition, and comfort care, which includes measures to ease suffering.
  Use that information to compile a document. The document that details your preferences about health care is called an advance directive. There are two main types of advance directives: a living will and a health-care power of attorney. An advance directive goes into effect only if you’re incapacitated and unable to speak for yourself. There are additional legal documents that can either complement your advance directive or stand on their own.

  3. Determine your desire for special orders. You may opt for a do-not-resuscitate order, which tells doctors that you don’t want them to attempt to return your heart to normal rhythm. If you would like your organs and tissues donated, make this request clear in your advance directive.

  4. Choose a health-care proxy. A health-care proxy is a person who will act on your behalf when you are unable to. Pick a family member or friend who shares your views about medical decisions. You can also determine how much—or little—authority your proxy will have over your medical care. In addition to a primary health-care proxy, chose a backup who will ensure that your medical preferences are carried out as your alternate proxy in case the primary proxy is unavailable. Be sure to confirm that the proxy and alternative proxy accept and are comfortable with their roles.
  
  5. Sign on the dotted line. Fill out the forms that will detail your medical care preferences. You could hire a lawyer, but many states offer resources to complete this process yourself. You can find the most suitable forms for you by calling 800-677-1116 or visiting www.eldercare.gov. You may need a witness or be required to have your signature notarized.

  6. Share your advance care planning with others. Provide copies of your advance directive to your health-care proxy and alternative proxy. Your doctor and hospital staff should also have copies. Close family and friends should have a copy to ensure that they know your wishes. Keep a list of who receives a copy, in case you need to make changes.

  7. Review every few years. An advance care plan isn’t a static document. It can change with you. Every few years—10 years at the most—review your advance care plan. You may need to make adjustments based on changes to your health, if you’ve become married or divorced, or if you need to name a new proxy.