Advance care planning
Advance care planning is an organized process of communication to help individuals understand, reflect upon and discuss goals for future health care decisions in the context of their values and beliefs.
An advance directive is a legal document in which a person specifies what actions should be taken regarding their health care if they are no longer able to make decisions because of illness or incapacity. There are two primary types of advance care directives:
• Power of Attorney for Health Care / Health Care Proxy is when the person authorizes health care agent(s) to make decisions on their behalf. It does not overrule a living will. The form has to be witnessed. In most states, the form does not have to be notarized. A copy should be given to the agent(s) and physician(s). Keep a copy with you. Share and discuss your wishes with family members, friends and caregivers.
Health care agents must be at least 18 years of age and trusted to do what’s best for you. Discuss with them if you have an existing advance directive (living will) that contains your wishes; if you would rather be at home or in the hospital during the last days of your life; and your religious, spiritual and cultural beliefs and how important it is for you to avoid pain and suffering. They will also make decisions regarding medical tests and procedures; accepting, withdrawing or declining treatments that keep you alive; and, agreeing or declining to donate organs.
• Living Will is a written, legal document that allows one to leave instructions for their medical and end-of-life care. It must be witnessed by at least two adults. It documents one’s desires to be kept alive by artificial means — tube feedings, dialysis, ventilators — and to be, or not to be, resuscitated.
If there is no Power of Attorney for Health Care or Living Will, the doctor will ask a family member, friend or guardian to make decisions. This individual is called a “surrogate.” Surrogates are required to make medical and life-sustaining treatment decisions in accordance with the person’s wishes. The surrogates can be (in this order) a court-appointed guardian, spouse, any adult child, either parent, any adult sibling, any adult grandchild or a close friend.
A surrogate may make decisions only when the following conditions have been met: 1. Two physicians agree that the patient lacks decision-making capacity. 2. At least one of the following situations apply: the condition is terminal, incurable or irreversible. 3. The patient is in a state of permanent unconsciousness.
Advance directive forms may be provided by your physician, hospital and attorney. Advance directives may be revoked at any time. There is no expiration date unless stated on the documents. Check with your state or states that you will be residing in for their specific guidelines on advance care directives. The documents do not cover financial matters.
Rev. Jiles Taylor-George, RN, BSN, MSN, is a native of Tallahatchie County and a certified caregiver support group facilitator.
