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Planning for the Future: Advance Directives
April 14, 2020
This week marks National Healthcare Decisions Day, a day dedicated to encouraging people to take action and create advance directives. An advance directive lays out what medical treatments you want (or don’t want) when you’re unable to communicate with your doctor.
Advance directives can be a challenging topic to discuss. “People often don’t want to think or talk about their death or the death of loved one,” says Dr. Luz Ramos, chief medical officer for InnovAge’s eastern region. “But there is often a sense of relief when we discuss it because it allows them to share their wishes with their caregiver, family members, and their physician.”
What someone includes in their advance directive is a very personal decision. “It depends on your values, culture, religious beliefs, and more,” Dr. Ramos explains. At InnovAge, PACE physicians talk about advance directives with participants and their family caregivers.
“We talk through the issues and their current understanding of their medical care and answer questions so we can record the participant’s wishes and can support them. Understanding someone’s goals and what is important to them allows a healthcare provider to honor their wishes for their care in life-threatening circumstances. It also helps their caregivers and families to come to the terms with the realities of their prognosis, and, in effect, avoid unwanted hospitalizations and decrease family conflict.”
Common Questions about Advance Directives
The most important thing, says Dr. Ramos, is to push past the initial discomfort to start the conversation. Knowing your priorities and sharing those with your doctor can help come to a common understanding. Sharing your decisions with your family, and being sure they, your doctor, and your attorney have a copy of your directive, can make a highly emotional and often confusing time go much smoother.
Advance directives can be a challenging topic to discuss. “People often don’t want to think or talk about their death or the death of loved one,” says Dr. Luz Ramos, chief medical officer for InnovAge’s eastern region. “But there is often a sense of relief when we discuss it because it allows them to share their wishes with their caregiver, family members, and their physician.”
What someone includes in their advance directive is a very personal decision. “It depends on your values, culture, religious beliefs, and more,” Dr. Ramos explains. At InnovAge, PACE physicians talk about advance directives with participants and their family caregivers.
“We talk through the issues and their current understanding of their medical care and answer questions so we can record the participant’s wishes and can support them. Understanding someone’s goals and what is important to them allows a healthcare provider to honor their wishes for their care in life-threatening circumstances. It also helps their caregivers and families to come to the terms with the realities of their prognosis, and, in effect, avoid unwanted hospitalizations and decrease family conflict.”
Common Questions about Advance Directives
- How do I create one? Start with a conversation with your doctor. Your doctor can help document your decisions using widely available templates. Laws can vary by state, so sometimes it can be helpful to talk with a lawyer.
- When can I create an advance directive? Advance directives can be created any time.
- Can I change it? Yes, you can change your wishes at any time. Life changes like marriages and divorces can be good reasons to update your directive.
- What is a living will? A living will is a type of advance directive.
The most important thing, says Dr. Ramos, is to push past the initial discomfort to start the conversation. Knowing your priorities and sharing those with your doctor can help come to a common understanding. Sharing your decisions with your family, and being sure they, your doctor, and your attorney have a copy of your directive, can make a highly emotional and often confusing time go much smoother.
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