National Healthcare Decisions Day is in April, and it highlights the importance of advance care planning.
Advance care planning is about deciding what you want from health care if you are in a situation where you are unable to voice your wishes. It’s an important conversation and one that should begin at a young age and continue throughout your life, says Deborah Potticary, a Middlesex Health Palliative Care advanced practice registered nurse.
Advance care planning discussions often lead to advance directives, which is a document that details what you do and don’t want in a terminal situation when it comes to health care. For example, would you want to be kept alive by machines or have a feeding tube?
Advance directive forms do not need to be authorized by an attorney. The paperwork can be found online, and you just need two witnesses (who are not related to you) to be present when you sign it.
“We don’t like to think about what happens when medical treatments are limited as an illnesses progresses, but we need to,” Potticary says.
It is important to note that an advance directive is not legally binding, but it serves to inform your health care team and loved ones what your wishes are. As such, Potticary says it is important to keep the form in your home and to give a copy to family members, your physician and to your hospital. You may also want to assign a health care decision maker who can act on your behalf in an emergency – during a time when you are not able to direct your health care.
When you are faced with a life-limiting illness or a chronic health disease, advance care planning conversations are less hypothetical and more specific. These individuals focus on what they are going through and any limits to care they want to impose based on their condition. At this point, Potticary says getting an active order from a physician may be a good idea.
In 2017, Connecticut’s governor signed a bill that created a Medical Orders for Life-Sustaining Treatment (MOLST) program. This allows physicians, such as primary care doctors or oncologists, to mandate that health care providers respect the wishes of patients who have life-limiting illnesses or chronic health diseases. MOLST forms are very specific, and physicians have in-depth conversations with patients about their wishes.
Because the MOLST form is new in Connecticut, you may have to ask your physician about it. A Palliative Care physician or an advanced practice registered nurse can complete this form with you and help you advocate for your own wishes.
The bottom line
Potticary says advance care planning conversations are a safety net. It’s best that these conversations don’t happen during a medical crisis when people are emotional. You should put some thought into what you want.
“It’s not about death,” Potticary says. “It’s about life. What we are really talking about is quality of life, and only a patient knows what quality of life means to them.”
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