Advance Directives: For You, For Your Family
All of us hope and anticipate that we will always be able to speak for ourselves and make our own decisions. However, if you were to become very seriously ill or injured and not able to communicate, who would speak for you? Who would make decisions about your healthcare? How would your healthcare team know what you wanted in the way of medical treatment?
Planning Ahead Can Be a Gift
An advance care plan can be a gift you give yourself and your family. A plan gives you the opportunity to provide your loved ones peace of mind that they will know what to do on your behalf should the need arise. While many of us do not think we will ever need a plan, too often the lack of one can result in questions, confusion, and disagreements on the part of family members trying to envision what you would want. A plan relieves them from having to guess whether they did the "right thing." A plan also helps your healthcare team make treatment decisions that reflect your preferences and values.
Think, Decide, Communicate, and Document
Advance care planning is not difficult but it does involve having thoughtful conversations with close family members or other loved ones about your care wishes and preferences, and documenting those preferences in writing through an instrument such as an advance directive or living will. Among the decisions to be made and documented is the name of the individual you have chosen to serve as your "healthcare proxy," or the person who will be responsible for making decisions for you on your behalf if the need arises. This person is someone you trust to help ensure that your wishes are honored and carried out.
A Lack of Planning Has Economic Consequences
At times, a lack of advance care planning results in unintended and unnecessary medical expenditures. Most terminally ill people would prefer to die at home, with family members and other loved ones present. However, the experiences of most seriously ill and dying are the opposite of what Americans say they want. About two-thirds of Americans die in institutions such as hospitals and nursing homes, and many spend extended periods in intensive care settings. This reality often translates into substantial expenditures by individuals and their family members for medical treatment that the individual may not have wanted.
A lack of advance care planning, coupled with our rapidly aging society, also has a tremendous effect on our nation’s healthcare resources. More than 25% of all Medicare expenditures are for care during the last year of life. This is true despite the fact that many Americans have expressed preferences for “no heroic measures” when faced with a terminal condition. Documenting in writing what you would want and sharing your plan with your family, other loved ones, and healthcare providers helps to ensure that your wishes will be honored and carried out.
Where You Can Go for More Information
CDC's On-Line Course
Professionals in the public health and aging networks are in unique positions to help educate the public on the role and value of advance care planning. CDC now offers an on-line course especially for this audience. The course is free of charge and offers continuing education credits.
Many materials are available to help people better understand the value of advance care planning and how to complete a plan. Learn more about resources on advance care planning and related topics such as hospice, palliative care, caregiving, cognitive impairment, and relevant legal issues. While the list of resources is not exhaustive, it represents a variety of materials that you should find helpful, including tool kits, sample plans, and state-specific guidance.
Learn more about National Healthcare Decisions Day and watch a video highlighting the value of advance care planning.
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