Advance Care Planning

Advance care planning is a process of learning about, reflecting on and discussing preferences for future medical care, including end of life decisions.

A Gift to Family and Loved Ones

  • It’s important to discuss and record wishes, yet few do so.
  • Advance care planning decreases hospital stays and hospital days at end of life.
  • Advance care planning increases likelihood of passing away in one’s own home, which 80% of people state they would prefer.
  • No advance care planning correlates with a higher risk of prolonged grief.
  • Higher risk of PTSD if loved one passes away in an intensive care unit.
  • Avoiding unwanted and futile interventions means better and more appropriate care.

Advance Care Planning Involves:

  • Understanding the kind of medical problems you might experience in the future and determining how you would want to be treated under those circumstances, assuming you are unable to speak for yourself at the time.
  • Reflecting on possible future care in light of current medical technology and on your personal, religious or cultural preferences.
  • Discussing your choices with health care providers and loved ones.
  • Communicating your wishes to others through various documents generally referred to as advance directives, which come out of the advance care planning process. These documents communicate your wishes to others. 

Types of Advance Directives

1. Durable Power of Attorney for Health Care (sometimes called Health Care Proxy or Medical Power of Attorney)

  • Names a person (or persons) you choose to make health care decisions on your behalf when you are unable to speak for yourself.
  • In the absence of a Durable Power of Attorney for Health Care, Washington state law designates the legal decision-makers in the following order:
    1. Court-appointed guardian (if any)
    2. Spouse
    3. Adult children (all must agree)
    4. Parents (both must agree)
    5. Adult brothers and sisters (all must agree)

In the state of Washington, advance directive forms do not have to be notarized to be legal documents unless a notary signature area is part of the document.

2. Directive to Physician (also known as a Living Will)

  • Explains your wishes and choices regarding care in the event you have a terminal condition and are unable to speak for yourself.
  • Typically addresses topics such as medical nutrition, ventilator support and end-of-life wishes.
  • Provides direction for care, but cannot cover all the possibilities one may face.

3. Physician Orders for Life-Sustaining Treatment (POLST)

  • A POLST is a prescriptive instruction to Emergency Medical Services and your health care team that communicates your wishes related to resuscitation.
  • A POLST is intended for those with life-threatening illnesses, advanced disease, age and/or frailty, to ensure your wishes are communicated to others.
  • Because a POLST “belongs” to a patient, the form should remain with you and travel with you to any setting (home, hospital, nursing home, etc.).
  • A POLST can be initiated by other members of the health care team such as your nurse or a social worker, as well as by your health care provider.
  • To be valid, a POLST must be signed by a physician, nurse practitioner or physician assistant involved in your care.
  • A POLST should be posted prominently in your home, such as on your refrigerator door, in case you are found unconscious.
  • In the state of Washington, a POLST is generally bright green for easy visibility.

Advance Directives Can Help:

  • Individuals, by protecting their rights to accept or refuse medical treatment, and by directing choices that affect their care.
  • Families, by potentially relieving the stress of making difficult health care decisions for a loved one.
  • Healthcare teams, by providing important guidelines for care.

Learn More - Begin the conversation with your loved ones

These websites provide additional information on advance care planning.

Have questions on advance care planning? Contact us at WhidbeyHealth.