Advance care planning is essential to ensure your end-of-life wishes are honored. You have several options regardless of where you live.
Information in this and the next section has been adapted from National Hospice and Palliative Care Association.
An advance directive, also known as a living will, allows you to document your wishes concerning medical treatments at the end of your life. However, emergency medical technicians cannot honor your advance directive.
You must meet certain conditions before a living will can guide medical decision-making. The laws governing advance directives as well as the titles of advance directives vary from state to state; some states honor advance directives from another state, others do with limitations, and others still don’t at all. Complete your advance directives for all the states where you spend a significant amount of time.
Your advance directive never expires; it remains in effect until you change it. Every new advance directive invalidates the previous one. Review your advance directive periodically to ensure that it still reflects your wishes. If you want to change anything in your advance directive, create a new advance directive.
Medical Power of Attorney
A medical power of attorney (or healthcare proxy) allows you to appoint a person you trust as your healthcare agent (or surrogate decision maker). Your healthcare proxy is authorized to make medical decisions on your behalf, but only if you are unable to make your own medical decisions.
POLST (Physician’s Orders for Life-Sustaining Treatment)
POLST allows for your healthcare wishes to become a part of your medical chart. Benefits participating in a POLST program include:
- ease of access to your advance care documents;
- increased likelihood your healthcare wishes will be honored during an emergency;
- and portability (POLST forms can follow you from institution to institution).
Advance Care Planning for Alzheimer’s Disease or Dementia
While Alzheimer’s and other dementias are daunting diseases to face, advance planning may help provide a small amount of control to those who need it the most.
None of the three states with Death with Dignity laws allow individuals whose judgment or decision-making is impaired by dementia or Alzheimer’s disease to take part (people with early-stage dementia without cognitive impairment do not qualify because they do not have a terminal diagnosis).
Our friends at End of Life Washington have developed the Alzheimer’s Disease and Dementia Mental Health Advance Directive. Endorsed by the Western and Central Washington State Chapter of the Alzheimer’s Association, this document allows you to outline your preferences for care across many life dimensions, including behavior management, personal and daily activities, and intimate relationships. Though the form is written for Washington state residents, it can serve as a way to document your wishes and guide discussions with your family.
Comfort Care and Pain Management
- Caring Connections is a program of the National Hospice and Palliative Care Organization (NHPCO) that provides free resources, information and motivation for actively learning about end-of-life care and options.
- The American Academy of Hospice and Palliative Medicine and the Center to Advance Palliative Care provide information about comfort care and how to find a palliative doctor near you.
- The Center to Advance Palliative Care also evaluates how palliative care rates in each state.
- MyDirectives is an online system for documenting your end-of-life wishes.
- EverPlans is an interactive site that helps you plan for death both in the distant future and near term, outlines what needs to happen after a death, and provides tips for supporting the bereaved.
- The Conversation Project and Death Cafe are programs that help conduct conversations about end-of-life care, death, and dying.