ADVANCE HEALTHCARE PLANNING
• Inform your healthcare team that you have completed advance care directives. You may have worked with someone on your healthcare team to complete your advance care directives, or they may have been placed in your medical records during a hospitalization. However, many healthcare providers are not alerted to this fact and may not be aware that you have completed advance care directives. Discuss your wishes with your healthcare team and inform providers during hospitalizations or clinic visits if they do not ask. You can provide them with a copy and ask them to confirm that it has been included in your electronic medical records. Also inform professional caregivers, staff of long-term care facilities and hospice teams of your wishes and the location of your directives( or copies of them).
Answers to frequently asked questions:
• When is the right time to complete advance care directives?
It is never too early to discuss care wishes and decisions with your family and healthcare team, as this helps to relieve the burden of not knowing what you may have wanted. Getting everyone on the same page and having open and safe conversations, especially when not in a time of crisis, can offer comfort and peace of mind for you, your family and your healthcare team.
It is helpful to complete your Healthcare Power of Attorney and Living Will as early as possible. For DNR / DNI and other medically-ordered directives( e. g., POLST), most people who complete them do so when they are at higher risk of hospitalization and complications or when they have more complex medical needs, including chronic and progressive health conditions. However, you can complete DNR / DNI and other medically-ordered directives at any time, especially if you have very strong preferences about these interventions.
• Can advance care directives be changed or undone?
Yes! While they are legal documents, they do not have to be set in stone and can evolve as your wishes for care may change over time, which often happens as we age, reflect on experiences and live with different and changing health conditions.
It is helpful to review your advance care directives periodically to confirm that they still reflect your current wishes. You can end or update an advance care directive at any time by informing your healthcare team and healthcare power of attorney and writing“ void” on the previously created documents, and / or by completing an updated document.
Additionally, many U. S. states will recognize advance care directives created in other states, but they may not be considered legal. If you move to a new country or state, it is important to update your advance care documents to those legally recognized and valid in your new location.
• Where should I keep these documents?
Many people seem to think that copies of advance care directives should be kept in a safe deposit box with other important papers; however, a safe deposit box can be difficult to access at times. Keep a copy of your Healthcare Power of Attorney and Living Will at home in a safe and easily accessible location. Also give a copy to your Healthcare Power of Attorney and one or two other close family members. It is helpful to have extra copies on hand as well, in addition to making sure it is put on file with your healthcare providers in your electronic medical record. Some U. S. states maintain registries that allow quick access by proxies and healthcare providers.
For DNR / DNI and other medically-ordered advance care directives( e. g., POLST), keep these in a prominent location that would be visible to medical personnel, such as next to the bed or hanging on the front door or refrigerator. Bring the original document with you in the event of a hospitalization or stay in a rehabilitation or long-term care facility.