It is never too early or too late in life to put your affairs in order. In part 1 of this series of posts, we talked about the importance of a financial power of attorney. Today, we consider advanced care planning (ACP).
The Colorado Department of Public Health and Environment explains that ACP “allows individuals to share and document their wishes surrounding serious illness, incapacitation, and end of life.” With comprehensive planning, future medical care and end-of-life treatment is more likely to be well coordinated and in accord with the patient’s personal wishes and values.
Advance medical directives
Advance medical directives, also called advance health care directives, are legal tools to help people with three main issues:
- Who will make medical decisions on your behalf if you cannot communicate your wishes?
- How will medical professionals and your medical agent know your treatment wishes?
- What are your directions for end-of-life treatment, including use of life support and resuscitation?
According to Colorado Care Planning, about two-thirds of older Coloradans have advance directives as compared to about 45% of older Americans nationally. So, we are doing relatively well in Colorado, but there is room for improvement.
Identify your priorities
To work through your feelings and make decisions about future treatment, talk to family, close friends and your physicians. Your doctors can explain the kinds of decisions you might want to make ahead of time, the pros and cons of certain treatments and what they are, and anything that you should consider if you have particular health conditions.
These topics may be difficult and uncomfortable but working through your feelings about medical treatments if incapacitated or at end of life can help you solidify what directions you want to specify in your advance directive.
Choosing a medical surrogate
In Colorado, a medical durable power of attorney is the legal document in which you name your medical agent (also called medical surrogate or medical decision-maker) and any alternate agents. Your agent will have the authority to act on your behalf if you are temporarily or permanently incapacitated or unable to communicate your wishes at the end of life.
Consider whom you might name as your health care agent (as well as one or two alternates). Who do you trust to follow your wishes and understand your likely feelings in a serious medical situation? Talk the role over with potential agents to see if you both are comfortable with them taking it on for you.
Instructions for future treatment
In a living will you can direct which medical treatments and interventions you either want, would like to try (and stop if not effective) or refuse if you develop a terminal medical condition. Examples of the kinds of treatments may want to consider are CPR, life support, pain control, hospitalization, use of a ventilator for artificial breathing, blood transfusions, dialysis, nourishment, hydration, antibiotics, surgery and others.
Besides these two main documents, others are available like the cardiopulmonary resuscitation (CPR) directive and medical orders for scope of treatment (MOST).
Thorough advanced care planning can be a blessing to your family and close friends because they will know what you want and who will decide for you at a difficult and sad time. If you do not put legal direction in place, it may be necessary for the hospital to identify interested persons in your life to help make decisions, or the court may need to appoint a guardian for you.