Advance Care Planning

A few months ago, I spoke with the spouse of one of our residents. She shared that she and her friends recently had a deep, meaningful discussion about their preferences for care as they grow older. At the time, she was facing some tough decisions regarding her husband’s care, and the opportunity to share these challenges with her friends proved invaluable. It also reminded her of previous conversations she and her husband had shared with their children.

The best way to ensure you receive the care you want is to discuss or document your wishes in advance. Although these conversations can be challenging, they significantly reduce the burden and stress on your loved ones later. Research shows that for half of all adults over 65 who are hospitalized, someone else is involved in making their medical decisions.

What is Advance Care Planning?

Advance care planning is the process of discussing and preparing for future healthcare decisions, especially if you become seriously ill or unable to communicate your preferences. At the heart of this planning are meaningful conversations with those you love.

When beginning this process, healthcare professionals often ask, “Do you have a patient advocate—someone designated to make medical decisions for you?” and “Have you completed a Durable Power of Attorney for Health Care?” If the answer is yes, that’s wonderful. If not, now is the time to complete a Durable Power of Attorney for Health Care. There are helpful resources online, including forms from organizations like Making Choices Michigan or “A Guide to Medical and Legal Decisions – Planning for Your Peace of Mind.”

Diving Deeper

Before finalizing your Advance Directives, it’s helpful to discuss your views, values, and specific wishes for your care. Without clear communication, your values may not be fully honored.

There are some great resources out there that will help you explore your values, thoughts, and desires for your care. Check out the links below!

Advanced Care Planning: A Conversation Guide www.nia.nih.gov/health/advance-care-planning

Institute for Healthcare Improvement  – The Conversation project    theconversationproject.org

Advance Directive for Dementia: Dementia-directive.org

Making Choice Michigan: Making Choices Michigan – About – MiHIN

Starting the conversation

Begin by sharing your wishes for future care with your loved ones. Speak openly about your values, thoughts, fears, and hopes. These discussions don’t need to be profound from the start. Look for a natural opening, perhaps prompted by a news story or a friend’s health situation. For example, you might ask, “What would you want done if you were in that situation?” or share, “If that were me, I would prefer…”

You might also consider saying, “Even though I’m healthy right now, I want to be prepared. What do you think?” This can help start a dialogue in a gentle, open way.

Consider questions like:

• What matters most to me as my health declines?
• How do I envision the last phase of my life?
• When would I want my care to shift from curative to comfort-focused?

Share your information   

Ensure that your healthcare providers and facilities have a copy of your Durable Power of Attorney for Health Care. Your healthcare proxy and close family members should also have this information so they can act in alignment with your wishes.. 

Review and Revisit

It’s wise to periodically review your Advance Directives and related documents to confirm that they still reflect your current wishes. Update them as needed and share the revised versions with relevant people.

There are many resources available online to support you in exploring these topics further. If you would like more in-depth assistance, consider consulting with a social worker or care manager. Reviewing your legal documents with a lawyer periodically is also recommended.

Resources:

National Institute on Aging
The conversation project