Last time, we addressed the “C” of Advance Care Planning. This time we address the next and final letter, which is “P”. We know that “P” stands for “planning,” but it also stands for “publish” and “print.” Once you’ve chosen your health care agent (“A”) and had the family conversation (“C”), it’s critically important that your plan be put in writing, signed and made available to all those who will need it. It must include two parts at the very minimum: the Durable Power of Attorney for Health Care (designating your health care agent) and a living will. Without a written document, your wishes may not be known or executed as you desire.
An advance directive is a legal document, so it must meet your state’s legal requirements. You can find the requirements by consulting your state’s statutes. An easier way to go is to use the Five Wishes advance directive, which is published and distributed by Aging with Dignity, a non-profit organization whose founding was inspired by the life and work of Mother Teresa. The beauty of Five Wishes is that it is easy to understand and use and meets the legal requirements of 42 states and the District of Columbia. In the remaining eight states you must take additional steps. (There is a federal law that says health care providers must honor any valid expression of a person’s wishes, but these matters are usually decided in the states.) These states require you use and sign their official state form, but you can attach it to your completed Five Wishes.
Why put it in writing at all? Because people are human and they forget. As a nurse, I have been at the bedside of someone who could no longer speak for themselves. There is nothing I like more than to have a Five Wishes available at the bedside of my patient. It allows me to provide better and more personalized care. In one case the designated health care agent was agonizing over making treatment choices because he just didn’t feel sure he was making the “right” decisions because he couldn’t remember the original conversation held years earlier. It is then that the living will portion of the written document can come out and refresh the health care agent’s memory. Suppose the health care agent isn’t available when he’s needed? The living will portion can still help guide the health care staff in your care. And knowing just how a patient desires to be treated makes my job that much easier.
Finally, once you’ve put your wishes to writing, sign it and follow the witnessing instructions in Five Wishes. Make photocopies of the completed document and give one to your physician for your medical file, one to your health care agent and copies to any others you choose. Always keep the original in a place where you can get to it if need be, and complete the wallet card so you can carry it with you.
M. Jane Markley RN, MEd, FACHE is a consultant with over 30 years of experience in healthcare and is the president of M Jane Markley Consulting, LLC.