End-of-Life Planning

Advance care or end-of-life planning encourages you to record and share your healthcare preferences with providers and loved ones. putting everyone’s mind at ease. By understanding and expressing your desires with a sound mind you can you can articulate what it means to live — and die — on your own terms.

There’s no official checklist that tells you what you have to consider in your advance care planning. You can decide the scope of topics and level of detail for yourself, however end-of-life care planning usually includes the following concerns:

• Medical intervention. Are there situations in which you would refuse certain medical treatments or care? You may feel that some health states are worse than death.
• Decision maker. There may come a day when your doctor must ask your spouse, siblings, or children for decisions about your care. Are they prepared for this responsibility? Do they want it? Would someone else be better able to carry out your wishes? Advance care planning can help clarify roles.

You may choose to complete an advance directive form as part of your advance care planning. This form is a good start and will help guide discussion and decisions.

Sometimes circumstances — like a hospitalization — will prompt a care-planning discussion. In other cases, you can choose your own time to bring up these topics.

There’s no “perfect time” to start your planning. Still, after looking through this booklet, you may feel that some of the issues raised in care planning are best considered before a medical emergency arises.

You don’t know what the future will bring. But you can make care plans today that help you face it with more confidence and clarity.

Talk to the people close to you, those who might be called upon to make decisions for you. Talk with as many people as you feel comfortable with. But realize that if you’re in the hospital at some point, it’s best for the medical staff to have one person — your healthcare agent — they can go to for decisions. Be sure to let your loved ones know whom you’ve chosen.

Many social workers, counselors, lawyers, and medical care providers also have experience and training to help you and your loved ones make these plans.

While each individual’s end-of-life plan and preferences will differ, there are a few topics you may want to address:

1. Values. Do you have fundamental beliefs about life and medicine? Do you believe that life should be preserved at all costs? Do you believe that life should not be prolonged through extensive intervention? Are some medical treatments against your beliefs?
2. Issues. The medical treatment you want may depend on your changing health and situation. Consider your prognosis, treatment, and level or setting of caregiving needed.
3. Scenarios. Even if you’ve thought about your basic beliefs and the factors that may influence care decisions, it can be difficult to predict the right plan for you. It may be easier to think about what you might want in a specific situation, such as a stroke, Alzheimer’s or dementia, or a vegetative state.