Your Advance Directive: Step 1 – Think About It
Advance care planning allows you to control the end of your life while you are still healthy and active. You can choose who will speak for you by completing a healthcare power of attorney, a legal form to name your healthcare agent. You can also help them choose what types of treatment you would want by completing a living will. As you begin to plan, consider each of the following things that can impact the choices you make.
What a Healthcare Agent Does
If a sudden accident or illness leaves you unable to speak for yourself, your healthcare agent will be able to make medical care choices for you including but not limited to the following:
- Choosing your doctors and facilities
- Reviewing and sharing your medical information
- Making decisions about your medical treatment
- Starting or stopping life-prolonging machines and treatments that sustain your body
- Performing an autopsy and making decisions about your body after death
If there are specific decisions you don’t want your agent to be able to make, you have the option to limit their power. On the North Carolina healthcare power of attorney form, include your limitations in the special instructions section. On the South Carolina healthcare power of attorney form, use the designated section for limiting an agent’s power.
Who Can Be Your Healthcare Agent?
Your agent does not have to be a family member. This person does not have to know your entire medical history, but it is a good idea to include them in conversations with your doctor about your current medical conditions when possible. When choosing your agent, certain requirements must be met. Your healthcare agent:
- Must be at least 18 years old
- Must be competent to make legal decisions
- Cannot be someone you pay for healthcare services
Below are a few questions to help you in deciding who would be the best person to choose.
- Who do you feel comfortable talking to about sensitive topics?
- Who do you feel would honor your wishes?
- Who do you feel can make difficult decisions during stressful and emotional times?
It is a good idea to choose a back-up agent, in case your agent is unable to speak for you.
Choosing Your Care
Like most people, you probably don’t want doctors to stop caring for you when the end of your life is near, but you want to die peacefully and free from pain. Making choices now about the type of treatment you want or don’t want can relieve some of the stress from your loved ones in the future. Below are some questions that may help you. Every answer will be unique to you and can be helpful in making choices for your future care.
Questions to ask yourself:
- What is most important to you?
- Who or what gives your life meaning?
- What is an acceptable quality of life for you?
- What do you believe would be worse than death?
- If you were having a great day, what would you be doing?
- Do you have any cultural traditions that would impact the healthcare choices you make?
- Do you have any spiritual beliefs or practices that would impact the healthcare choices you make?
- Do you have any spiritual traditions or practices that bring you comfort?
- Has someone you know ever become seriously ill or been injured unexpectedly? How do you feel that person’s experience impacted you?
Many people would choose to focus on how they are living as the most important factor in their decision-making. Others want to live as long as possible, even if they require constant medical care. To help you make these difficult decisions, review the statements below and think about how you feel about each option.
My biggest fears are:
- Pain and suffering
- Being a burden to family
- Loss of body function
- Loss of mental function
- Death
- Being a financial burden
- Fear of being left alone
- Other fears you have
- I don’t have any fears
If there comes a time when my health gets worse and I feel the end is near, my goal would be:
- To focus on how I am living rather than how long I am living
- To keep myself alive by a feeding tube if I can no longer eat by mouth
- To keep myself alive even though I do not know who I am or who I am with
- To keep myself alive even if I cannot walk or get out of bed
- To keep myself alive on machines no matter what
- To keep myself alive on machines for a set time
In my final days, I would like to be:
- At home
- In a healthcare facility
There may come a time when these difficult decisions have to be made for a child. Many parents who have been through this say being prepared for the end of their child’s life helped them feel they had some control. Parents also felt that having a plan allowed them to stay focused on the time they had left with their child. More information about making healthcare choices for a sick child can be found on the Courageous Parents Network.