Healthcare Decisions Day 2022: Start the Advanced Care Planning Conversation
According to Caring.com, nearly 67 percent of Americans do not have plans in place to account for their assets or end of life decisions. Most of us live our lives with little attention paid to things like long-term care planning and it’s not until a medical emergency or health crisis – our own or that of someone we love – that we suddenly find ourselves feeling unprepared.
National Healthcare Decisions Day is April 16, and the idea behind it is that we shouldn’t wait for personal crises to bring to light questions about our own health and future.
Instead, we should challenge ourselves to lean into the conversations – admittedly sometimes uncomfortable - about how we’d like decisions to be made on our behalf should we be unable to make them ourselves. Failing to map out what’s important to us leaves those decisions to our next of kin or the state to decide.
Advanced care planning usually begins with thinking through and expressing your personal end-of-life goals to family and friends to align your values with the care you want to receive (or don’t want to receive) and incorporate any religious requests and cultural considerations. Medical emergencies are not the time to have these conversations; times of crisis can be overwrought with emotion, or you may be incapable of communicating for any number of reasons. It’s important that your medical team, family and friends have already been informed of your preferences and choices ahead of time.
This month is the perfect time to start this process, and the two most important documents to begin your planning are the Advance Directive and POLST.
This document provides the detailed legal instructions for your medical team, family and friends about what is important to you in the event you become incapacitated. With the help of a lawyer, this document also allows you to legally name someone to make health decisions on your behalf in the event of incapacity. At the time of a medical emergency, you may not be able to communicate, so this document gives that person the medical direction they need to make informed decisions on your behalf. It also directs the medical staff about with whos they can communicate about your care and from whom they can take advice.
A POLST is a portable medical order. In Oregon, there is a state POLST form you can fill out with a health care provider that essentially turns your medical wishes into documents that can travel with you across care facilities to help care providers better understand and honor your wishes. These get documented in your medical records, but also serve as an on-the-go document available in case of emergency.
In the absence of the direction these documents give, health care providers will automatically perform treatment focused on saving your life. This is called the standard of care - but depending on where you are in your life and what your beliefs may be, this standard may or may not suit your interests. That is exactly why the legal frameworks and medical directives determined as part of advanced care planning benefits everyone.If you are looking for more information and guidance about how to make informed health care decisions, check out these resources:
The Conversation Project, an organization helping people share their wishes for care through end of life.
Being Mortal: Medicine and What Matters in the End by Atul Gawande.
Go Wish has free conversation cards translated into many languages to provide an easy way to open discussions about your needs and wishes.
Advanced care planning is not something that typically rises to the top of our favorite things to do list. But hopefully these resources can help you get started by speaking with your health care provider, family and friends to ensure that they understand your needs and wishes.
Special thanks to guest blogger Elena Fracchia, MPA, CWS®, CEPA™ , VP of Wealth and Philanthropic Advisor at Columbia Bank Wealth Management in Eugene, for sharing her expertise!