It’s never a bad idea to have a plan — especially when it will impact your quality of life.
“Most patients have no idea that hospitalization is coming, and many people don’t realize they likely aren’t going to be able to make their healthcare wishes known when it’s most important,” warns Joelle Vlahakis, MD, medical director of Sarasota Memorial’s Palliative Care Services. “It’s best to think about that before you need to.”
Advanced care planning gives you a say in the medical care you receive if injury or illness leave you unable to speak for yourself. Advanced care planning is the process of making decisions about the healthcare you would want and documenting it to ensure your wishes will be followed. While this kind of future planning may be daunting, it’s best to weigh your options and make these important decisions when you’re of sound mind and body.
What is “Advanced Care Planning”?
Advanced care planning provides a roadmap and parameters for your medical team so that your healthcare will proceed in accordance with your values and wishes, regardless of your ability to express them in the moment.
This roadmap will detail your preferences for a range of medical care options, including treatments (procedures or life-sustaining methods); care duration and locale; end-of-life preparations; and quality of life measures. This often means making decisions about receiving:
- CPR
- Artificial respiration
- Artificial nutrition
- Organ donation (or donating your own organs)
- Blood transfusions
An important part of the process is communicating these decisions to your doctor and loved ones, and documenting them through a living will, advance directive or similarly binding record. Because preferences may change over time, these documents can be easily amended or replaced.
Who Needs Advanced Care Planning?
A common misconception is that living wills and advance directives are for the elderly or those living with serious medical conditions or terminal illness. The truth is that advanced care planning is something that everyone should make time for, regardless of age or health.
A health crisis can hit anyone at any time — no matter their age or current health — and can leave them unable to make healthcare decisions.
An accident or illness might result in temporary cognitive impairment. Perhaps a needed medication interferes with immediate decision-making. Or a tragic incident leaves them unable to communicate at all, possibly facing end-of-life versus quality-of-life determinations.
Without a plan in place, medical care teams and family members must make these decisions, in the throes of a crisis and without the patient’s input.
Have the Conversation
“The single most important thing you can do is to have a conversation about what’s most important to you,” Vlahakis explains.
It could be a conversation with a loved one such as a parent, sibling or child, a spiritual leader, or your doctor — whomever you feel comfortable with discussing these issues and who you’re confident will communicate your wishes if you cannot.
The planning process is not only a chance for you to formulate your thoughts, feelings and preferences, but also to explore the entirety of your care options.
“A good place to start is to think about the things that are really important to you and give you joy,” Vlahakis says. 
“What’s most important to you? What could you live without? Some might be willing to put up with loss of a limb or inability to speak. Some of us would be OK as long as we had speech. These are questions we all have to ask ourselves.”
Consulting a doctor about personal and family medical history, as well as genetic testing, can help determine some potential scenarios that could arise and what care options would be available.
Make a Record
The best way to ensure that your wishes are known and honored by your family and healthcare team is to document them in an official written record such as an advance directive. An advance directive is a witnessed and signed legal document, such as a living will, outlining your advanced care planning decisions and often ascribing power of attorney to a healthcare guardian.
“Write. It. Down,” says Vlahakis, noting that a care plan need not be complicated. “The best ones are the shortest ones. Don’t feel like you have to get fancy.”
Patients are advised to always take along their advance directive documents whenever they check in to a hospital, to guarantee that healthcare providers have easy access to and are aware of their decisions.
Advance directive laws can vary state to state, but your local hospital or local Area Agency on Aging can help you through the process.
As a Sarasota Memorial copywriter, local journalist and in-house wordsmith Philip Lederer, MA, crafts a variety of external communications for the healthcare system. He earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, Ky.