Important Steps to Start Advance Care Planning

You may have heard the phrase “it always seems too early until it is too late” when referring to many plans we make in our lives. Nothing could be further from that truth when dealing with who would make health care decisions for you if you suddenly could not make them for yourself! As a physician caring for those with serious sudden illness or rapidly progressive chronic illness, I have difficult conversations daily. The conversations are challenging when the patient or family has never thought about “what matters most” and what that looks like in their situation.

What is advance care planning?

Advance care planning is not just the completion of a form (living will or healthcare power of attorney). It should include conversations with those you love and trust about the many things that are important to you as you age and as illness progresses.

Once you’ve thought about what you want and talked to your loved ones, it’s time to write down your wishes. At Ochsner Health, we’re using new electronic technology through MyDirectives to provide an easy-to-use “Five Wishes” document. Visit MyDirectives to create an account or learn more.

The Five Wishes are:

The person I want to make care decisions for me
This allows you to name someone you trust to make medical decisions for you if you are unable to do so. (healthcare power of attorney)
The kind of medical treatment I want or don't want
Here, you can express your preferences for specific types of medical care you want when you are unable to communicate and not expected to get better. (living will)
How comfortable I want to be
This part focuses on your comfort and pain management. It allows you to specify how you want to be cared for if you're in pain, or how you want your emotional and physical comfort to be prioritized.
How I want people to treat me
This section addresses your personal and emotional needs, such as how you want to be treated by those around you: your family, friends and caregivers.
What I want my loved ones to know
The final wish allows you to share your thoughts, feelings and final wishes for your family and loved ones, to help them understand your end-of-life decisions.

The technology allows proper witnessing and storage within your medical record and would be available to you and those decisions makers in real time 24/7. When properly signed and witnessed it is legal in all 50 states. This also enables you to record a video message to your family if interested.

These discussions and decisions may be the best gift you can give your family. Importantly, the healthcare power of attorney, also known as a surrogate decision maker, is the person you have chosen to make decisions for you. It may be your best friend, niece or son-in-law rather than any of your children.

The Five Wishes document guides you through discussing details with your family and decision makers allowing you to write those conversations and decisions down as clearly as you can. Remember that no decision about these things is really a decision but it may lead to unnecessary turmoil in your family long after you are gone. These conversations could change the lives of those you leave behind.

What is National Healthcare Decisions Day?

National Healthcare Decisions Day, held annually on April 16, reminds us “it always seems too early until it's too late.”

This phrase serves as a prompt for all patients to think of who they would want to make healthcare decisions for them when and if they cannot make those decisions for themselves and what those decisions might be. Many people (healthcare professionals included) think something like this will never happen to them.

We all know of someone who experienced a sudden or a chronic illness which rapidly worsened that had not made any plans, thus leaving their family, friends and healthcare team to make tough decisions without much direction. Those watching a scenario like this unfold are often heard saying, “I hope that never happens to me” or “I hope my children act differently toward each other.” But then they never put those thoughts in writing or tell others what they would have wanted in a similar situation. “It always seems too early until it is too late!”