Advance Care Planning

Advance care planning is an important part of planning for the future and ensuring your wishes regarding healthcare and end-of-life are followed. Sometimes because of illness or injury people are unable to talk to a doctor and decide about treatment for themselves. You may wish to plan in advance to make sure that your wishes about treatment will be followed if you become unable to decide for yourself for a short or long time period.

If you don’t plan ahead, family members or other people close to you may not know your wishes. A law in New York State allows a family member to make decisions on your behalf. You may wish to designate someone ahead of time who might not be the same person selected under the state law.

Definitions

Typically, advance care directives fall into the following categories:

  • Health Care Proxy — someone you designate who can can make decisions about treatment if you become unable to decide for yourself.
  • Living Will — a document that allows you to designate what types of health care intervention you want or don’t want should you become incapacitated and unable to state your wishes at the time of your health care crisis.
  • MOLST form (medical orders for life-sustaining treatment) — is a medical document your physician fills out with you to document your wishes. Since this document is filled out and signed by a physician it is a medical order that can be followed by anyone involved in your health care. As long as they know it exists and have a copy available to reference. In some states this type of document is called a POLST form, for physicians orders for life-sustaining treatment. Generally the MOLST form is only completed for patients with serious medical situations, terminal illness or who do not want any type of medical intervention, except comfort care.

Online resources

Many websites have collected information on advice on advance care planning:

  • New York State’s advance care resources provide links on advance directives, including forms for a Health Care Proxy and Living Will.
  • Compassion and Support at the End of Life. A community coalition in Rochester compiled links to advance care planning guides and forms. Information available in English and Spanish.
  • CaringInfo is a program of the National Hospice and Palliative Care Organization (NHPCO) that provides resources to individuals in making decisions about their end-of-life choices. The advance care planning section of their website includes links to download advance directive information from each state.
  • Consumer’s Toolkit for Advanced Healthcare Planning from the American Bar Association, helps guide conversations between you and your loved ones about advanced healthcare planning.
  • The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care.
  • Sharing Your Wishes is a program aimed at helping older adults become aware of the importance of planning in advance for their health care in the event that they experience an illness or condition that prevents them from making or communicating decisions. This is the best way to ensure that their choices are known, understood, and honored. Sharing Your Wishes programs, located in seven counties throughout Western and Central New York, is an effort is supported by the Community Health Foundation of Western and Central New York.
  • Five Wishes helps people with living wills. It is written in everyday language and designed to help start and structure important conversations about care in times of serious illness. In addition to addressing basic steps such as naming a healthcare proxy and identifying what medical interventions you do or do not want, Five Wishes provides space to share your “personal, spiritual and emotional wishes”.

Why it makes a difference

Read more in our Hospicare blog about the importance of sharing and documenting the type of care you wish to receive.