Advance Healthcare Planning: What Are You Waiting For?

Throughout the month of April, MHA is re-doubling its effort to bring attention to the importance of advance healthcare planning – that is, the process you want your loved ones and caregivers to help you carry out if you become seriously ill.

If you have a plan in place, arrived at after conversations with those close to you, it will ensure that your family will not be burdened with making tough decisions on your behalf if you become seriously ill, and that your wishes will be carried out. Having a plan in place can also avoid disputes between family members who may have differing ideas about the care you should, or should not, receive. And avoiding those disputes, which often occur in care settings, assists the caregivers at your bedside as well, who will be able to provide the care you wish free of conflict.

Does your personal physician know how you want to be treated if you are seriously ill? Does anybody close to you know? Do you have your wishes outlined in writing?

National Healthcare Decision Week this year occurs from April 16 to 22. The decision week is an initiative of The Conversation Project, working collaboratively with the Institute for Healthcare Improvement. This month, MHA will educate its staff, its surrounding community, and its membership on the importance of advance healthcare planning. Information about such planning will be outlined in weekly Monday Report stories throughout April.

This week, after surveying its staff, MHA is providing all of its employees with a “Getting Started Tool Kit” from Honoring Choices Massachusetts. MHA is also reaching out to its neighbors in “The District” – the Burlington, Mass. executive park where our offices are located, to provide them with information about advance care planning and access to the Honoring Choices Getting Started Tool Kit. That toolkit allows any competent adult over the age of 18 to:

•        Choose a healthcare agent in a healthcare proxy;

•        Write down their choices for care in a personal directive;

•        And learn how to talk to their care providers to align their care to their choices.

So where to get started? First, choose a healthcare agent – someone who knows and can convey your care wishes – in a healthcare proxy, which is a legally binding document. Be aware that under Massachusetts law, a spouse or family member does not automatically have the legal authority to make decisions unless appointed in a healthcare proxy.  You do not need an attorney to appoint a healthcare agent; you can do it yourself by filling out the proxy form in the toolkit and having it witnessed and signed by two adults. In the proxy you can outline the extent of the authority you are giving your agent.

Once appointed, what is your agent supposed to do? How does that agent know what you want? This is where the personal directive comes in. A personal directive is not a legally binding document but it does lay out in detail specific information about your wishes and instructions about the kind of care you want. You can discuss your values, religious and cultural beliefs, and your choices in a personal directive.

The healthcare proxy and the personal directive “work hand-in-hand,” according to the Honoring Choices tool kit. “You appoint an agent in a health care proxy with the legal power to make healthcare decisions on your behalf, and give your agent essential information and instructions about the care you want in a personal directive.”

Finally, the toolkit provides a discussion guide to help you talk to your care providers about your wishes, concerns about your current or future care, and about how to get information about your healthcare agent and your personal choices entered into your medical record. It’s important to outline your information and to have it accessible in the event you can’t speak for yourself due to an emergency or illness.

There are a lot of moving parts to advance care planning and a lot of different overlapping terms. But much of the information available to the public is clearly written, with easy-to-follow steps.  While the decision to begin a conversation about serious illness and end-of-life care is almost always a difficult one to make, avoiding such a conversation now may make things more difficult for you, your loved ones, and your healthcare providers further along in your life.

For more information, visit PatientCareLink and click on “Healthcare Planning Throughout Your Life” under the For Patients & Families Tab, or “Serious Illness Care” under Improving Patient Care.