To plan for healthcare decisions, individuals in hospice need to be able to understand their treatment options and be able to express their values and wishes.
What is advance care planning?
Advance care planning facilitates on-going, meaningful conversations by identifying patients’ values and beliefs around medical care decisions.
Why is advance care planning important?
- Before an illness or serious medical condition, advance directives can prevent unwanted medical procedures.
- Peer to peer conversations offer a safe, comfortable format to discuss healthcare decisions.
- Self-advocacy encourages your healthcare team to support your personal values and healthcare goals.
Understanding treatment choices, values and wishes.
Legal documents known as advance care directives allow your medical wishes to be known and enable you to designate a decision maker if you become unable to speak for yourself. They help ensure that your choices will be honored. The following list includes legal documents relevant to end-of-life decision-making and care. Some of these documents require legal counsel.
- Medical Durable Power of Attorney (MDPOA)
- Colorado Cardiopulmonary Resuscitation (CPR) Directive
- Five Wishes
- Proxy Decision Maker
- Power of Attorney (POA)
- Durable Power of Attorney (DPOA)
- Living Will
A MDPOA is a signed document that gives authority to an adult, at least 18 years of age, allowing him or her to make necessary medical and healthcare decisions should you become incapacitated. This document does not need to be notarized or witnessed, and it does not need to be completed by an attorney.
A CPR directive is a document stating that emergency healthcare personnel or others may not perform CPR on you. This document is available from a healthcare provider and must be signed by both you and your doctor.
Five Wishes is an advance directive document that addresses and documents your personal, emotional and spiritual needs, as well as your medical wishes. It also allows you to choose the person you want to make healthcare decisions for you if you are not able to make them yourself (in lieu of the MDPOA document).
Five Wishes encourages you to talk with your family, friends and doctor and tell them exactly how you wish to be treated if you become seriously ill. This directive can be very helpful for family members since they will no longer be required to make difficult choices and determine your wishes about your healthcare without sufficient information.
A proxy decision maker is the individual appointed to make healthcare decisions when a MDPOA has not been identified. The appointment is made by mutual agreement (consensus) of family members and interested persons.
A POA is a notarized document that assigns authority to an adult at least 18 years of age allowing her or him to make decisions regarding your money or property. This document ceases to be in effect at the time of death.
A DPOA is a notarized document stating that the designated POA can continue his or her authority to make decisions regarding your money or property even if you become incapacitated, disabled or incompetent. This document ceases to be in effect at the time of death. Please note that the Social Security Administration will require you to complete one of its forms as well.
A statement to this effect must be included in the POA document: “The power of attorney will continue to be in effect even if I become disabled, incapacitated or incompetent.”
A living will is a document signed by a person that instructs his or her doctor regarding the use of artificial life support measures if the person becomes terminally ill and is unable to make medical decisions. In Colorado, Living Wills may also be used to stop tube feeding and other forms of artificial nourishment but only if the Living Will clearly indicates this instruction and the person has a terminal illness. If the patient is able to swallow food and/or fluids, the Living Will won’t prevent the patient from being fed.
The Living Will must be signed by two witnesses but does not need to be notarized. Neither witness can be a patient of The Denver Hospice, any person associated with The Denver Hospice, any physician, employee of the person’s primary physician, or persons who may inherit any of the patient’s money or property.
Living Will forms and other information regarding Living Wills can often be obtained through doctors, lawyers, healthcare facilities, other health organizations or an office supply store.