ADVANCE CARE PLANNING

Advance Care Planning is a process of communication between an individual and their family members, loved ones, and/or health care providers to determine care choices. It requires a careful exploration of personal values, beliefs, and life experiences. Guiding Wishes can help you address some necessary and often confusing questions:

  • What kinds of medical interventions would you want or not want if you were confronted by a serious illness? What if that illness became terminal?
  • What do the terms CPR, DNR, artificial hydration and nutrition, and life-sustaining treatment really mean?
  • Who would you wish to make medical decisions on your behalf if you became incapacitated and unable to communicate?

Once decisions are made, they need to be documented in the form of Advance Directives. These include:

Living Will

This is a written statement detailing a person’s wishes and preferences regarding future medical care. This document can come in many forms and is often included in trust and estate planning as part of a will. In some cases, the Living Will may also designate a surrogate medical decision maker (see next).

Health Care Proxy

This is sometimes referred to as a Durable Power of Attorney for Health Care. In this legal document, an individual designates an official surrogate decision maker (“Health Care Agent”) to make medical decisions in the event they are not able to communicate due to advanced progression of illness. Ideally, those decisions should be consistent with the patient’s known wishes.

Advance Care Planning is a continuous process that may evolve and change over time based on health and medical circumstances. Guiding Wishes can facilitate these sensitive conversations with an individual and/or that individual’s family members and assist with completion of Advance Directive documentation.

MOLST (Medical Orders for Life-Sustaining Treatment)

In contrast to an Advance Directive, a NYS MOLST (known as POLST/MOST in some states) is a legal form that outlines medical orders specifically for patients with advanced or terminal illness and reflects their preferences regarding life-sustaining treatments, such as resuscitation, intubation, and a feeding tube. Although the MOLST must be completed with and signed by a qualified medical provider (physician, physician assistant, or nurse practitioner), as well as the patient or the patient’s Health Care Agent/surrogate, Guiding Wishes can walk you through the care choices and explain their implications.

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