Advance care planning
Planning in advance for the type of medical care you wish to receive if you can no longer communicate your wishes or make decisions for yourself
Not unlike other kinds of life planning (e.g. retirement planning), advance care planning is the act of proactively researching and making decisions for the kinds of medical care you want to receive at the end of life. You can document your decisions in advance directives like a health care proxy form and living will. You are planning “in advance” of when these decisions are needed.
A document that provides instruction for medical treatment and healthcare decision making, in the event you cannot communicate or make decisions for yourself
An advance directive is the result of advance care planning, and usually has two parts:
- 1. A health care proxy form allows you to identify a person (or persons) as your health care agent to make medical decisions for you.
- 2. A living will is a document that declares what you want those healthcare decisions to be.
Laws differ from state to state. Some states combine these documents into one form. Locate your state-specific advance directive forms here to learn more.
Artificial nutrition or hydration
A medical intervention or treatment that supplies nutrition and/or fluids when an individual is no longer able to take them by mouth
Cardiopulmonary resuscitation (CPR)
A life-saving technique used to attempt to restore heartbeat and/or breathing with chest compressions and/or an assisted breathing apparatus
Do-not-intubate order (DNI)
Do-not-resuscitate order (DNR)
A mechanical intervention used to purify the blood when the kidneys can no longer sufficiently perform this function on their own
An umbrella term that includes advance care planning and other planning topics like legal/financial, funeral, and legacy decisions
Health care agent(s)
The person (or persons) you designate on a health care proxy form to make medical decisions on your behalf, in the
There are several other terms used to describe the same role: healthcare power of attorney, health care proxy, health care representative, and health care attorney-in-fact are some of the common terms used in different states.
Healthcare power of attorney
Health care proxy (HCP) form
A legal form used to designate a person (or persons) to make medical decisions on your behalf, in the
This designated person is referred to as a health care agent. In most states, you can designate a person as your primary or alternate health care agent. If you list primary and alternate agents, some states allow you to choose how these individuals should make decisions – either in succession or together. Health care proxy forms differ from state to state. Locate your state-specific advance directive forms here to learn more.
The surrogate may be a spouse, family member, or friend who is available and willing to make decisions for you. In the event multiple people are available to assume this role, the attending physician will decide who is most competent to appoint. In the event physicians are unable to locate next of kin, a state-appointed entity may be chosen to assume this role. It is important to designate a health care agent with a health care proxy form to ensure someone that understands your values and preferences is making decisions on your behalf.
Medical care that prioritizes caring and comfort for patients nearing the end of life
While some health insurance plans allow patients to pursue curative treatments while receiving hospice care, many do not. Hospice care is delivered in a treatment facility, and sometimes at home, depending on the individual’s health plan and individual preferences.
A document that states what kinds of treatments you do and
Living wills are legal documents that detail your preferences for CPR, feeding tubes, dialysis, blood transfusions, or other life-prolonging treatments. A living will is a type of advance directive. Laws and enforceability of living
Medical treatment that uses a machine to assist with a patient’s breathing. Also referred to as a respirator or ventilator, the machine makes breathing easier for the patient and increases the amount of oxygen they receive
Medical Power of Attorney
An approach to medical care that focuses on improving the quality of life for patients facing serious illness or end of life
The goal of palliative care is to prevent or relieve suffering through the treatment of pain and other problems facing patients. Palliative care is appropriate at any age or stage of illness and can be provided on its own or in addition to curative treatment.
Patient Self-Determination Act (PSDA)
A federal law requiring that most hospitals, nursing homes, and HMOs routinely provide patients with information on advance directives at the time of admission
The law specifically requires that:
- 1. Patients are given a written summary of healthcare decision-making rights
- 2. Healthcare institutions ask patients whether they have an advance directive
- 3. Healthcare institutions train their staff about advance directives
- 4. Healthcare institutions may not discriminate against patients based on the status of their advance directives
POLST (Physician Orders for Life-Sustaining Treatment) form
A form created by a physician to record the decisions of terminally ill or frail people near the end of life who want to specify the types of care they do and do not want to receive
This form is not intended for healthy individuals. If you are terminally ill or frail, your doctor can help you create this document. Some other acronyms you may come across are MOLST, MOST, POST, COLST, TPOPP. To learn more about POLST forms, visit POLST.org.
Power of attorney (POA)
A person you choose to make legal and financial decisions on your behalf when you are unable to do so yourself
You can have the same individual as both your power of attorney and health care agent or you may elect two different people. Multiple types of power of attorney exist. Depending on which type is selected, legal power can take effect at different points in time:
- Non-durable POA – used for a set period of time or for a given event or circumstance
- Durable POA – used to manage all affairs of an individual until they are able to do so themselves or until they pass away
- Springing POA – used at a future point when a specific event triggers, or “springs”, the power of attorney into effect -- this power can be non-durable or durable