What is advance care planning and how can you complete it? Our team here in Bucks County is here to help you, your friends, and your loved ones put together these important documents so your wishes are clearly understood and legally stated should something happen to you.
Medical science has improved dramatically in recent years, to the point that we are able to save the lives of people who would surely have died only a few short decades ago. This has been a great blessing for many, but it has also led to situations in which unresponsive individuals who have no reasonable hope of recovery are kept alive for extended periods of time.
Often, at the end of our lives, we are unable to speak for ourselves to define what level of care we would like to receive. For this reason, BCHIP provides an Advance Healthcare Directive form to help people think ahead about what care they would like to receive and what decisions they would like made on their behalf, should they become incapacitated and unable to make these decisions for themselves.
The sections of the Advance Healthcare Directive that you will have to consider include:
- Whether or not you will want life-sustaining medical care, what kind, and under what situations
- Whether or not you want to donate your organs or tissues, if you are a candidate
- What you consider your acceptable quality of life
- What comfort care you would like provided
- Any other instructions you would like followed, regarding moral, religious, or ethical considerations
These issues are not easily or quickly answered. They require some thorough research on your part to understand the terms and what procedures are covered under each. You should then take time to deeply reflect on what would be the best decision for you and your family based on your ethics and beliefs. No one should push you to decide in any particular way, but make sure you are fully informed.
What does “life-sustaining” mean?
Life-sustaining treatment refers to treatment that sustains life and that without which, based on reasonable medical judgment, the patient would die. Since this definition is very broad, it can span many treatments that are considered standard care, such as insulin or dialysis. So you may want to make sure that such a broad definition is not used in your case. Many people live very full lives with life-sustaining procedures or treatments.
However, there are some treatments or interventions for a patient for whom death is fairly imminent—for instance, using mechanical means to sustain the heartbeat or breathing of a patient who no longer shows brainwaves. If this is your definition of life-sustaining and you do not want this type of intervention, you should clearly define this in your Advance Healthcare Directive.
Who will administer your wishes?
Once you have thought through these issues and have made some choices about your future healthcare, you will need to decide who will speak for you when you cannot speak for yourself and ensure that your wishes are followed.
Choose someone who shares your values about matters of life and death. You will want to choose more than one person since you will need an alternate agent in case your primary agent is unavailable. In fact, BCHIP recommends two alternate persons, if possible.
Many patients choose a spouse as the primary person and children or other close relatives as alternates. However, a close friend is also an excellent choice if you have shared values. Have a sincere conversation with these people, and explain your decisions and the research you did in order to inform yourself. Be open to their suggestions, as they may have additional information to help you in your decision process, but maintain your moral and ethical position, even if you see benefits in adjusting some of your original thoughts based on their input. These people love you and want the best for you.
Once you have completed your Advance Directive, make copies for each of your health care agents, keep a copy in your own home in a place that is easy to find (and tell your family where it is), provide one to your lawyer if you have one, and request that your primary physician make your Advance Directive a part of your permanent medical record.
You can update or adjust your Advance Directive at any time. Just make sure you provide updated copies to these individuals. It is wise to keep the older version with the newer one in your home, with the older version clearly marked VOID and the date of the newer version written on it
By taking these steps, you will be able to ensure that your healthcare preferences will be followed, should you be unable to speak for yourself.
