Imagine that while on the way to work last week, your spouse was involved in a multi-car collision and now lies in the hospital unresponsive, on total life support, and you’ve been told by the physicians that you may soon have to make a decision about continuing life support. What do you do? You had general conversations about what you both would and would not want done, but you never put anything in writing because you believed you would have so much time before you would have to make such a decision. Now your in-laws are insisting that “everything” be done, while you, as a healthcare professional, understand that making the decision to let go may be the best choice for your spouse. If only we had gotten around to talking about the very difficult idea of end of life and made our decisions known in writing…
As difficult as it may be to have to make healthcare decisions for a loved one and follow through, not having their preferences in writing can make the process even more difficult, frightening and isolating. But it doesn’t have to be this way. Advance care planning can help make the process less difficult and give you and your loved ones’ peace of mind that the right decisions were made and carried through.
What is advance care planning? Simply put, it is the process of making future decisions about your healthcare known now. It includes clarifying your values and desires; expressing your preferences; identifying healthcare preferences you do and do not want, and who can make decisions about your healthcare if you are unable to do so.
Making advance care plans often starts with talking with your loved ones, your healthcare providers, and significant others in your life that you want to know your decisions about your healthcare if you are unable to speak in the moment. It is difficult, but necessary to ensure that your wishes are carried out as you would like.
Next, talk with the person you want to make your wishes known if you are unable to do so. Ask if they are willing and able to take on this responsibility. If not, then you can choose another family member, friend or even attorney to execute your wishes.
Then your decisions must be made in writing. This is a critical step, as many of us may talk in general about what we do or do not imagine we want, but without specific written instructions, it is difficult or impossible to carry out these wishes. There are two major documents used in advance care planning: The “healthcare power of attorney” (proxy, agent or surrogate are terms that may also be used); and a “living will.”
The healthcare power of attorney documents the person you select to be your voice for your healthcare decisions if you cannot speak for yourself. A living will documents the types of medical/healthcare treatments you do and do not wish if you cannot speak for yourself.
While we may all understand the need to set aside a little time to do this, many of us put it off since we believe we’ll “do it later on.” That’s where “National Healthcare Decisions Day (an entire week this year) can help. This year’s observation week is April 16-22, 2017. Special events are planned for each day of the week, as noted below:
The overall theme for 2017 is "It always seems too early, until it's too late."
Sunday (4/16): Prepare
A day to get resources together
Monday (4/17): Start with Yourself
A day to think about your own healthcare decisions
Tuesday (4/18): Family/Friends/Loved Ones
A day to discuss your wishes with others (and learn their wishes). Complete your own Advance Directives and share with others.
Wednesday (4/19): Spread the Word
A day to tell others that you've engaged in advance care planning and encourage them to do the same
Thursday (4/20): Facilities Focus
A day for healthcare providers of all sorts to promote advance care planning
Friday (4/21): Professionals Preparedness
A day to ensure that all professionals (healthcare, clergy, legal, and others) understand and can promote advance care planning
Saturday (4/22): Reflection and Readiness
Consider what worked well for NHDD week and file/share your advance care plans so they will be available if needed
As the leading healthcare quality improvement organization in the state and nation, the SC Association for Healthcare Quality (SCAHQ) and the National Association for Healthcare Quality (NAHQ) support this important effort and invite you to participate in your home, in your workplace, in your house of worship, and with the public. Copies of documents that are legal in our state may be found here.
Wanda Bartschat, MSA, RHIA, CPHQ, Nursing Project Specialist, Nursing Business Support, Palmetto Health Baptist, and President-elect SCAHQ
For SCHA's own resources on advanced care planning click here.