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Planning for End-of-Life Care

There may be times when you cannot make your own health care choices. Making an “advance health care directive” can help you plan your care by writing down your choices about the care you receive. You also can choose who may speak for you.

Making an advance health care directive can help your family and friends when you have a serious medical problem. When you write down your choices about the care you want to receive, you help them from having to make decisions without knowing what you would want.

Making an advance health care directive is important to do now, even if you don’t have a serious medical condition.

FIVE STEPS TO MAKING AN ADVANCE HEALTH CARE DIRECTIVE:

  1. Talk with your doctor
  2. Name a health care agent
  3. Decide your health care choices
  4. Write down your choices
  5. Share your choices

What is An Advance Health Care Directive?

An advance health care directive is a written document that includes information about the health care you want to receive if you are unable to tell your doctor. There are two main kinds of advance health care directives:

  • Living Will—this allows you to write your choices about life support and other medical care. These choices would be carried out only when you cannot understand, make, and voice your treatment choices and you either have an end-stage medical condition or are permanently unconscious. 
  • Health Care Power of Attorney—this allows you to write the name of the person you want to make health care choices for you. This person is called your “health care agent.” You decide what choices your health care agent may make, when they may make those choices, and how you want them to make your choices. An advance health care directive can include choices for both physical and mental health. You also could create a separate mental health advance directive.

Step 1:  Talk With Your Doctor

Talking to your doctor is an important first step in understanding advance health care directives. Your doctor can:

  • Help you understand your medical condition and decisions you may have to make about your care
  • Help you understand why there may be a time when you cannot make your own health care choices
  • Describe medical care that you may need if you are seriously ill, such as “life-support”
  • Explain the good and bad things that could happen from your medical care

Step 2:  Name a Health Care Agent

A health care agent is someone you pick to make health care choices for you if you are not able to make them for yourself. It should be someone who knows you well and you can trust. Your health care agent should be someone who:

  • Is an adult (18 years or older)
  • Is able to make hard decisions in stressful times
  • Is able to stand up for you to make sure that your choices are carried out as much as possible
  • Is likely to be available, able, and willing to make choices for you when you cannot speak for yourself

You may want to pick more than one health care agent. There may be times when one person is not available or able to serve. For example, your first choice may be away on vacation or too sick to make your health care choices.

Step 3:  DECIDE YOUR HEALTH CARE CHOICES

Decide what end-of-life or other future care you may want. Think about how you would like to be cared for if you have an end-stage medical condition or are permanently unconscious. You may want to make choices about:

  • Life-support and other treatments to keep you alive, such as tube feeding (artificial nutrition and hydration)
  • Pain control and other relief, which may make you sleep more and be unable to spend time with loved ones

Step 4:  WRITE DOWN YOUR CHOICES

Pennsylvania law does not require you to use a specific form when you make your advance health care directive. You may use the sample forms listed below, other sample forms, or you may write your own. Sample forms:

Once you write down your health care choices, sign and date your advance health care directive with two adult witnesses around you. If you cannot sign for yourself, you may have someone sign for you. However, your witnesses cannot sign for you.

Pennsylvania law does not require advance health care directives to be notarized. However, other states do. If you do have your advance health care directive notarized, it may help it to be followed if you receive care in a state with this requirement.

Step 5:  SHARE YOUR CHOICES

Once your advance health care directive is finished, keep it in a safe place. Make sure that your family or health care agent can get it, if needed.

Ask your doctors and other care providers to put a copy of your advance health care directive in your medical record. Take a copy with you if you are admitted to a hospital, nursing home, or other health care facility.

Give a copy to your health care agent (including the people who you name as alternate health care agents). Be sure to talk to them about your instructions, preferences, and goals for medical treatment, even if you have stated them in your advance health care directive.

Give a copy to close family members or others you think would want to help make medical decisions for you if you are too sick to do so. You also may want to give a copy to your spiritual advisor (pastor, priest, or rabbi) and your attorney.

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