Advanced care planning
Few people enjoy this subject, and it shows: about 80% of American adults say they don't want their life extended by machines, but fewer than one third have the documents in place to enforce that. A group of healthcare professionals in the Mount Washington Valley have been working to change that. They've started by giving staff at local healthcare organizations the resources to start this process for themselves, and it's been so helpful that we'd like to pass some of what we've learned to you.
People of all ages benefit from advance care planning. Even if you're still young, a car crash or sudden illness could put your loved ones in a difficult situation if you haven't made it clear what you want. And if you have aging parents you want to begin this conversation with, a good way to begin is by talking about what YOU want for the end of your own life. But where do you start?
Advance care planning starts with a conversation between you and the people who you'll want to be involved in decisions at the end of your life. Before having that conversation, you need to figure out who those people are, and think through your answers to the questions that will come up. These could range from what care you want in different medical situations, to whether you want to be buried or cremated.
Two organizations have workbooks that lead you through this conversation. Begintheconversation.org has a very extensive workbook which leads you through many of the things you may want to think through and document, including topics beyond medical decisions such as financial concerns. Theconversationproject.org has a shorter starter kit to help you get your thoughts together before having the conversation with a loved one.
Once you've thought through what you want and talked to the people who you want involved in these decisions, you need to document your wishes in order for them to have legal and medical power. The legal document used to do this is called an advance directive. This designates who you wish to make decisions for you if you are incapacitated (known as "power of attorney") and specifics about the medical treatment you want.
Maine's advance directive form is available at Maine.Gov through DHHS's Aging & Disability Services. New Hampshire's is available through Foundation for Healthy Communities at www.healthynh.org. In Maine, you can also use a document called Five Wishes, which goes beyond medical decisions to talk about your comfort and other things you want your loved ones to know, and is available at www.agingwithdignity.org.
If you are already seriously ill, you may also want to create a physician order for life-sustaining treatment, or POLST. This is an actual medical directive which has more immediate power and is a lot more specific than an advance directive. A POLST should be filled out with a health care professional and must be signed by a physician, so the best starting place is a conversation with your provider.
Many of the resources I've listed are most easily available online. If it is difficult for you to access them online, White Mountain Community Health Center has copies of the workbooks and forms available for free at our front desk during business hours, Monday-Friday 9 am - 4 pm.