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When it comes to end-of-life planning, it can be tempting to avoid the subject and tell yourself you'll make arrangements another day. After all, nobody ever wants to plan for a serious illness or injury. But being prepared for the unexpected ensures your wishes will be followed in the event of an emergency – or when you are unable to make decisions for yourself. That's why, no matter your age, it's a good idea for all adults to set up an advance health directive.
Advance Health Care Directive Documents
Preparing and organizing legal documents for your future can feel overwhelming — especially with the amount of confusion surrounding advance directives. While every state varies slightly regarding their specific requirements, we’ve outlined the basics of what you should know. First, let's look at the different types of documents that often get confused when discussing end-of-life planning:
- Advance Health Care Directive. Some of the confusion surrounding advance directives comes from the fact that they come in so many different formats. Essentially, an advance directive encompasses any legal orders concerning your wishes for future medical care. For example, a Living Will and Power of Attorney are both types of advance directives. These documents can become necessary during certain serious medical situations — such as a stroke, coma or dementia — when you are unable to communicate your wishes regarding your own health. You can update your advance directive at any time, should your healthcare needs change.
- Durable Power of Attorney (DPOA). Also called a medical power of attorney, this legal document grants someone you trust the authority to make healthcare decisions should you be unable to act for yourself. You can specify the scope and timeline of your proxy's authority, but it’s important to select someone you trust to act as you would wish in an emergency. It's also important to note that a DPOA is specific to your healthcare decisions — decisions regarding your finances or property will need a separate Power of Attorney, which can be set up with an attorney or financial planner.
- Living Will. A Living Will is a type of advance directive that you can (and should) put in place to state your preferences regarding end-of-life care. A Living Will can be useful for both doctors and families in the event that you are ever unable to make decisions for yourself. Decisions that might need to be made could involve the use of CPR, ventilators (breathing machines), dialysis machines (kidney machines) or artificial nutrition (tube feeding). You can also use your Living Will to note your preferences regarding organ donation, pain management and more.
- Physician Orders for Life-Sustaining Treatment (POLST) form. Unlike an advance directive, a POLST form is actually a medical order requested through your physician. Similar to other documents, a POLST form tells emergency personnel (such as paramedics and EMTs) how to treat you during a medical crisis if you're unable to speak for yourself. However, POLSTs are typically only ordered when a person is living with serious or life-threatening illness, or has reached an age when natural death is preferred. Without a POLST form, emergency personnel are required to provide every possible treatment in order to keep you alive. If you would like to complete a POLST form, talk to your healthcare provider.
End-of-Life Care Planning Checklist
Now that you understand the subtle differences in end-of-life care planning documents, it's time to consider the current state of your own affairs. Many people find it relieving (and even empowering!) to make these healthcare decisions ahead of time, taking the load off their loved ones' minds and their own.
- Choose your healthcare proxy and discuss your wishes. Even before you complete your advance directive, it's a good idea to have a conversation with the person/people you want to be your proxy and tell them what kind of care you do (or do not) want. You may also consider selecting a back-up person, should your first choice be unable to act on your behalf.
- Prepare your Advance Health Care Directive. Next, it's time to complete your advance directive. Through our Health Library & Resource Center, El Camino Health offers free consultation appointments to help you create this important document. Our professionally trained volunteers can help you identify your healthcare wishes, assist you in answering questions and completing the correct forms, and witness your signature. Click here to learn more or to schedule an appointment.
- Keep your information safe and accessible. Once complete, be sure to make copies of your advance directive and give them to your doctors, healthcare proxy and attorney. We also recommend keeping the original document somewhere safe and accessible — such as at the front of a labeled filing cabinet — and telling your healthcare proxy and members of your household where it's stored.
This article first appeared in the October 2022 edition of the HealthPerks newsletter.