Advance Care Planning: Health Care Directives

Advance care planning is not just about old age. At any age, a medical crisis could leave you too ill to make your own health care decisions. Even if you are not sick now, planning for health care in the future is an important step toward making sure you get the medical care you would want if you are unable to speak for yourself and doctors and family members are making the decisions for you.

What is Advance Care Planning?

Advance care planning involves learning about the types of decisions that might need to be made considering those decisions ahead of time, and then letting others know both your family and your health care providers about your preferences. These preferences are often put into an advance directive which is a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. This could be the result of disease or severe injury no matter how old you are. It helps others to know what type of medical care you want.

An advance directive also allows you to express your values and desires related to end-of-life care. You might think of it as a living document, one that you can adjust as your situation changes because of new information or a change in your health.

Advance Care Planning Decisions:

Sometimes decisions must be made about the use of emergency treatments to keep you alive. Doctors can use several artificial or mechanical ways to try to do this. Decisions that might come up at this time relate to: 

  • CPR (cardiopulmonary resuscitation)
  • Ventilator use
  • Artificial nutrition (tube feeding) and artificial hydration (IV or intravenous fluids)
  • Comfort Care

What is Comfort Care at the End of Life?

Comfort care is anything that can be done to soothe you and relieve suffering while staying in line with your wishes. Comfort care includes managing shortness of breath, limiting medical testing, providing spiritual and emotional counseling, and giving medication for pain, anxiety, nausea, or constipation.

Getting Started with Advance Care Planning

Start by thinking about what kind of treatment you do or do not want in a medical emergency. It might help to talk with your doctor about how your current health conditions might influence your health in the future. For example, what decisions would you or your family face if your blood pressure leads to a stroke?

If you don’t have any medical issues now, your family medical history might be a clue to help you think about the future. Talk with your doctor about decisions that might come up if you develop health similar to those of other family members. In considering treatment decisions, your personal values are key.