This post was written by Chris Brinneman, MSW, LCSW, manager, Advance Care Planning, Parkview Health.
In his best-selling book “Being Mortal: Medicine and What Matters in the End,” author, surgeon and public health leader, Dr. Atul Gawande, wrote, “Endings matter, not just for the person, but perhaps, even more, for the ones left behind.” When you engage in an advance care planning discussion and complete appropriate advance directive documents, you can identify your hopes, wishes, fears and concerns, tying your treatment preferences for future medical care to what matters most to you as an individual. Regardless of your age or health condition, your unique life experiences and beliefs help to inform personal medical decision making related to sudden illness or accident-related care, chronic disease management or end-of-life planning.
Despite a recent uptick in general understanding about the need for advance care planning, most Hoosiers have not completed advance directive documents. An advance directive (AD) is a legal document you can use: 1) to appoint a person to speak on your behalf in the event of the loss of decisional capacity or the ability to communicate, and 2) to express healthcare decisions and/or treatment preferences for future care. An advance directive is part of necessary pre-planning; a contract that can be changed at any time.
Updates to advance directives
Indiana recently updated the law regarding advance directives, allowing for greater flexibility in language and signing requirements, along with providing clarity regarding the role and responsibilities of the person you appoint to make decisions for you if you cannot. Your health care representative (HCR) must defer to you when you can make your own decisions. If you lose the capacity to make your own decisions, your HCR must take your known or implied preferences into account when making decisions and, if unknown, the HCR must act in your best interests.
The value of clear communication
Of those who have completed advance directives, many have not had conversations to prepare their chosen health care representative to speak for them, in the event of a medical crisis. That preparation involves having ongoing conversations, discussing personal or familial experiences with illness or injury requiring hospitalization and reviewing lessons learned, defining what a good day looks like, and reflecting on personal, cultural and spiritual beliefs.
Advance Care Planning (ACP) is all about communication – with your loved one, your physician and your healthcare team. ACP is necessary so that your healthcare team can honor your personal choices. Treatments only work if they work for you. You can speak up now to have a say in your care. You can start the process today!
Get started
Resources are available at Parkview Health to help you communicate your wishes to your family and care team in the event you are unable to speak for yourself.
If you have already completed your state-specific advance directive(s), you can now upload them to your Parkview medical record in MyChart. From the MyChart menu, search “Advance Care Planning” to upload documents, complete questionnaires, begin the process of adding your legally appointed healthcare agents, and view additional resources. In MyChart, if you want to start your ACP conversation and need assistance with completing appropriate advance directive documents, you can schedule an appointment with a certified Advance Care Planning facilitator.
You can also call the ACP referral line at 260-266-1481 or email acpdept@parkview.com to schedule a cost-free ACP appointment. Each certified ACP facilitator is trained to be a “guide by your side” as you consider hopes, fears and beliefs, and share information about what matters most with the people who matter most to prepare them to be your healthcare representative.
You can download the Indiana Patient Preferences Coalition standardized advance directive document here. You can also access nationally recognized ACP documents, including Five Wishes and Prepare for Your Care. Via their websites, you can complete their advance directive booklet electronically or on paper. All three of these forms meet Indiana’s legal requirements, consistent with the advance directive overhaul law. If you do not live in Indiana and would like assistance in locating your state-specific advance directive forms, please reach out to Parkview’s ACP team.
Endings matter. Participating in advance care planning and completing appropriate advance directive documents allows you to control both living and dying well.