This is the third and final installment of the Spotlight on Benefits’ series on advance care planning — the process of discussing and documenting your wishes for medical treatment or care in the event your doctor is unable to determine what your medical wishes may be.
So far, this series discussed the first three steps of the advance care planning process:
- Understand your current health status
- Reflect and prioritize your care goals
- Designate a health care agent
To read all the articles in this series, visit www.dgaplans.org/advancecareplanning.
This article discusses the final steps: create your advance directives, communicate your wishes to your health care agent and medical providers, and maintain your advance directives to ensure they reflect your current wishes and circumstances.
Create Your Advance Directives
Once you’ve determined your health care goals and designated your advocate, it’s best to formalize your wishes and choice of health care agent on legal documents called advance directives.
Advance directives include a variety of planning documents, each with its own purpose. Whether a specific directive is legally recognized, however, varies by state. The most often used advance directive forms are listed below:
Living will – documents the medical treatments/procedures you would like to receive or refuse. In most states, it will apply only if you meet specific medical criteria and are unable to make decisions.
Health care power of attorney – designates your health care agent and any alternate agents in case your first agent is unavailable. This form also lists your agent(s)’ contact information.
Do Not Resuscitate (DNR) order – communicates that you do not want treatment to restore cardiac activity and respirations in the event your heart stops or you stop breathing. However, unless your DNR order is valid and visible during an emergency, Emergency Medical Service (EMS) teams are still required to attempt resuscitation. Authorized vendors (e.g., MedicAlert) sell DNR bracelets and necklaces that alert responders and give them instant virtual access to your directive.
Physician Orders for Life-Sustaining Treatment (POLST) – a form intended for those of advanced age or for those who have serious, progressive illnesses that put them at risk of dying. This form gives more detailed information about your wishes for medical treatment in the event of an emergency.
Advance directives differ from state to state. If you spend a lot of time somewhere other than your state of residency, it may be useful to obtain legal advice to determine whether or not your advance directives will apply in each state.
Qualifying Health Plan participants and dependents can receive advance care planning assistance through the Motion Picture and Television Fund’s (MPTF) Palliative Care program, which supports individuals with serious, chronic and life-threatening conditions. Visit www.dgaplans.org/palliative-care for more information.
NOTE: Once you complete your portion of the documents, you may need to acquire witness signatures and notarization to make the documents legal.
Share Your Advance Directives
It may feel natural to keep your advance directives in a safe or safety deposit box along with other important documents; however, if that’s the only place you’ve stored them, no one will have access to them in the event you’re unable to open the safe or provide access instructions.
Instead, keep your original documents in a safe place, and give a copy of your forms to all your health care providers and to any health care institutions where you are receiving care. You should also provide physical and digital copies to any health care agent you named along with select loved ones to prevent potential misplacement of your wishes or interpersonal conflict down the line.
For emergencies, you can also keep a card in your wallet that has your health care agents’ names and contact information.
Maintain Your Advance Directives
Once completed, your advance directives may need to be revised as your life circumstances may change. To make changes to your advance directives or agent designation, consult your state’s specific requirements and follow your state’s guidelines to ensure your new directives supersede the old versions.
It’s good practice to re-evaluate your directives every 10 years and if
- your choice of agent(s) changes
- you get divorced
- you have a new, serious diagnosis
- your health declines
- you move or someone moves in with you
Help Your Health Care Agent Be the Best They Can Be
It’s recommended that you maintain communication with your health care agent(s) even after you’ve provided them with your completed legal directives. In fact, you can further help your advocate by communicating periodically with them in the ways below:
- Tell them where you keep your original directives in case they are requested in an emergency.
- Let them know of any changes to your wishes, health or goals.
- Provide any new or updated directive copies (print and digital) to your agent(s), and ask them to destroy any old copies.
- Introduce them as your health care agent to hospital or nursing home providers if you become sick.
- Explain or ask your doctor to explain to your agent(s) your medical condition and course of treatment. Provide them with an opportunity to ask the provider questions.
- Keep loved ones informed of your health status and the instructions you’ve given your agents, so that agents have a supportive network if they need it.
Conclusion
Advance care planning can be an intimidating task. Yet, with an honest and thorough reflection on your health, you’ll be in the position to make important decisions about your medical wishes and prepare someone you trust to execute them.
These proactive steps – though time-consuming – may bring you, your loved ones, your health care agent and medical providers invaluable peace when time matters most.
