Advance Care Planning: Conversations Worth Having
Planning for the future is important. Everyone needs to have a Personal Directive. We may lose our physical capability temporarily or permanently. We may lose our mental capability slowly, such as with Alzheimer’s disease, or very suddenly, as a result of a car accident. Stress among patients and their loved ones often stems from disagreements regarding health care decision-making at the end of life, including the choice of when to use or stop use of life-sustaining medical procedures.
Generally, the choices regarding medical care are within a patient’s control. However, it is important to realize that there may come a time when you will not have the ability to make these decisions yourself, due to medical reasons or otherwise. Preparing a Personal Directive gives you a voice in the care you will receive if you cannot make your own decisions at the time. It also helps those who will have to make personal care decisions for you. It may be the best gift you can give to your loved ones who may have to make difficult decisions for you in the future. It is important to talk about these issues with the people you trust—your family, friends, health care providers and spiritual advisors. Consider whom you would want to make decisions for you if you are not capable (temporarily or permanently) to make them yourself. Filling out a Personal Directive can be a way of sorting out your values, fears, hopes and wishes about how you want to live. It may take some time and help from others but it can be a very positive journey.
The Personal Directives Act is a new law that does three things:
It recognizes a Personal Directive as a legal document. A Personal Directive allows you to set out how personal care decisions, including health care decisions, are to be made for you when you are not mentally capable of making those decisions. It is only in effect when you are alive and mentally incapable of speaking for yourself.
It sets up a process that allows a person to appoint a delegate to make decisions about their own health care. A delegate is a person who has the authority to make decisions for you if you are not able to make decisions about your own health care. If you make a Personal Directive, you can name another person as a delegate to make decisions for you about your personal care.
It allows a person to set out their wishes for their personal care in a legal document. First, you can write down specific instructions for people to follow when they provide you with personal care services, if you become incapable of making decisions. If these instructions are clear, and specific to the decision to be made, they must be followed. Second, you can write down other information about your values, beliefs, and wishes to guide others who will be providing you with personal care services, if you become incapable of making decisions.