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Did you know that while 90 percent of people say that talking about end-of-life care is important, only 27 percent of people do?1 Although it can be difficult to think about the care you would want if you weren’t able to make your own medical decisions, having a plan in place is one of the most important ways to protect your rights and to ensure your wishes are respected.
Advance care planning isn’t just for very old or very sick people. It is recommended that everyone over age 18 have a plan in the event of a sudden illness or injury. It can also help you be prepared for serious illness or end-of-life care.
The advance care planning process includes:
There are many types of Advance Directive documents. Here are four common ones:
Health Care Proxy
A health care proxy is a written document that designates a person as your Health Care Agent when a doctor determines that you have lost capacity to make decisions for yourself. It also allows written statements about desired medical treatment decisions in advance. It is a good idea for everyone over the age of 18 to have one. Health care proxies can be designated for temporary situations (i.e., surgeries or sudden illness) or for permanent situations (i.e., if you are in a coma or if you develop dementia or Alzheimer’s). There is a simple form you can fill out yourself.
Download a Health Care Proxy Form.
A living will is a written document that allows you to state your wishes for different medical treatments in advance. Unlike a health care proxy, it does not designate someone you trust to make treatment decisions on your behalf, but can serve as evidence of your wishes as long as the directives are stated clearly and are updated regularly.2 You should discuss your medical care options with your doctor, including the pros and cons of prolonged medical treatment. This will help you make a decision that is right for you. Examples of medical treatments in a living will include mechanical respiration (machines that breathe for you), tube feeding, hydration/fluids, and pain relief/comfort care. There is a form you can fill out yourself. You can have both a health care proxy and a living will.
Do Not Resuscitate (DNR) is a medical order issued by a doctor, at your request. The DNR tells medical staff not to provide CPR (chest compressions) if your heart stops. A DNR order does not mean the withholding of all medical care, only CPR. DNR instructions can also be made known in a health care proxy or a living will. It is very important to discuss DNR with your doctor.
Do Not Intubate (DNI) is a medical order issued by a doctor, at your request. It specifies whether a breathing tube can be inserted in your throat. DNI instructions can also be made known in a health care proxy or a living will. Talk with your doctor about when intubation might be used and to see if it is something you would want.
If you are responsible for caring for a loved one who is considering hospice care, these articles provide guidance and valuable tips to support you in this important role.
For more information about hospice, advance care planning, or guidance on having conversations about end-of-life care, we recommend visiting the following websites:
Volunteers are the heart of our hospice program, providing an extra level of care and comfort that makes all the difference to patients and families. They work alongside trained staff, visiting patients and families, creating art at the bedside, or holding vigils for patients who are nearing the end of life without family around them.
We invite you to join us! Find additional details and contact information here.
1 The Conversation Project National Survey 2013.
2 A living will is not formally recognized under New York law, but some courts have allowed a living will to serve as evidence of a patient’s wishes if the directives were clear.