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Advance Care Planning Resources

Advance care planning allows you to have a say in your care by preparing you for future medical decisions.

  What is Advance Care Planning?
  • It is the process of learning about decisions that might need to be made in a medical emergency, thinking about those decisions ahead of time, and sharing your preferences with your provider.
  • It can help make sure that your loved ones and healthcare team understand your wishes.
  • Your personal values influence your preferences and can be recorded in an advance directive.
What are Advance Directives?
  • Advance directives allow you to have a say in your medical care if you are not able to speak for yourself.
  • They are documents and forms that describe your preferences about medical treatment.
  • There are several types of these forms.
  • Some forms are simple. Other forms allow you to document detailed medical preferences.

 

Appointing a Healthcare Representative
  • One of the easiest ways to make sure your wishes are followed is to choose someone to make medical decisions for you if you become unable to speak for yourself.
  • The healthcare representative form allows you to choose an adult who would make medical decisions for you if you became unable to make your own.
  • This is the simplest advance directive to complete and takes only a couple of minutes.
  • Choose an adult who 1) knows you well, 2) will ask your providers questions, and 3) will respect your wishes.
  • The Appointment of Health Care Representative form can be found at: https://www.indianapost.org/wp-content/uploads/2023/02/Indiana-Advance-Directive-2023-Representative-Appointment-Only.pdf.
  • Sign the form in the presence of two adult witnesses.
  • If you do not legally appoint a healthcare representative, your decision maker will be determined based on the Indiana medical consent hierarchy law in the following order:
    • A spouse.
    • An adult child.
    • A parent.
    • An adult sibling.
    • A grandparent.
    • An adult grandchild.
    • The nearest other adult relative in the next degree of kinship.
    • An adult friend who has maintained regular contact with the patient and is familiar with the patient's activities, health, and religious or moral beliefs.
    • The patient's religious superior.

 

Completing a Detailed Advance Directive
  • Consider what matters to you most and how this may influence future medical decision-making.
  • The following resources can help guide your thoughts as you reflect on what is important to you.
  • If you become unable to speak for yourself, these forms will also help providers design a plan of care for you based on your specific values and help your family and friends make decisions on your behalf.
  • The forms on these websites are appropriate for anyone 18 years or older.

 

Making Sure Advance Care Planning Counts
  • Discuss your wishes and advance directives with family and/or close friends.
  • Discuss your wishes and advance directives with your physician.
  • Revisit the forms at a minimum yearly with your provider to make sure they are still accurate. It is normal for your thoughts, perspectives, and viewpoints to change over time.
  • It is important to make sure that your completed advance directives are on file at the hospital. If you have already completed an advance directive, please:
    • Bring this in to be uploaded to your medical chart OR
    • Email your documents as an attachment to AdvanceDirectives@hendricks.org OR
    • Send your documents through MyChart.
Advance Care Planning MyChart

 

If You Have Chronic Illness
  • You may be a candidate for additional, specific types of advance directives, such as the POST or out-of-hospital DNR forms.
  • These must be signed by a physician and are considered physician orders.
  • If you are interested in completing these advance directives, please reach out to your primary care physician or request a referral to the palliative care team.
  • POST form (Physician Orders for Scope of Treatment)
    • Gives orders to medical providers regarding the following:
      • Resuscitation- also known as CPR
      • Intensity of medical interventions, including ventilation (a breathing machine)
      • Antibiotic preferences
      • Feeding tube and artificial nutrition preferences
    • Considered personal property that needs to be transferred between healthcare facilities.
    • Should be hung on the refrigerator.
  • Out-of-hospital DNR
    • Protects someone’s wishes not to be resuscitated (brought back to life) after they have passed away.
    • Gives orders to medical providers outside of the hospital.
    • Is personal property that needs to be transferred between healthcare facilities.
    • Should be hung on the refrigerator.

 

Six Important Steps of Advance Care Planning
  • Step 1: Think and Reflect
    • The first step is thinking about what matters most to you and how that might influence future health care decisions.
    • Some questions you can consider during this reflection:
      • What gives your life joy, meaning and purpose?
      • What does "quality of life" mean to you?
      • What would you be willing to give up or tolerate to keep what matters most to you?
      • Has anyone close to you died? Do you think their death was a "good" death or "bad" death? Why? What would you consider a "good" death?
      • Do you have a medical condition that may get worse, and how will this affect your quality of life?
      • Are you having medical treatments that affect your quality of life? What medical problems do you think you might have in the future?
      • Who would you want to speak for you about health care decisions if you could not communicate for yourself?
      • Are there circumstances when you would want CPR, mechanical ventilation, artificial nutrition, or artificial hydration? Are there any treatments you know you would want? Are there treatments you know you would not want?
      • Where would you prefer to spend your last few months, weeks, or days? In your home? Nursing home? Hospital?
Read Steps 2-6

Common Misconceptions

I need to have my lawyer complete this.

You can complete any of the forms above without a lawyer. The resources are all free. Only a POST or out-of-hospital DNR form requires a meeting with a physician and a physician's signature to become official.

I need a notary.

All of the advance directives listed above can be made official with witness and/or physician signatures.

Isn’t this just the same thing as a DNR?

There is much more to advance care planning and advance directives than discussing code status. Advance care planning is an ongoing process involving reflecting upon and sharing what matters to you rather than one specific decision about resuscitation. Your specific values can guide the type of care you receive at all stages of life and illness.

I only need to do this if I’m dying or sick.

It does become more important to engage in advance care planning if you are seriously ill. Starting this process earlier rather than later, however, helps to ensure that your wishes are honored if you were to become unexpectedly ill. Reflecting on what matters to you can help you become more prepared to make serious medical decisions in the future and may give your loved ones guidance on how to speak for you if tasked with making medical decisions on your behalf.