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End of Life Decisions – Having a Plan is Key

Thursday, January 24, 2013 4:19 PM

It’s not a topic we like to think or talk about, but whether we plan for it or not, each of us will reach the end of our lives at some point. “I wish we knew” is a phrase that medical professionals hear all too often when loved ones are in the difficult position of making medical care decisions for someone who is unable to speak for himself or herself.

Rev. Nancy Waite, Chaplain, Director of the Spiritual Care and Support Department, provides the following tips on how to start thinking about and planning your end of life wishes and preferences:

  • Make your plan before you become ill. The best time to reflect on, discuss and plan for a time when you cannot make your own medical decisions is when you are healthy.
  • Talk with your family or loved ones about your wishes. Communication is the most important aspect to consider with regard to end-of-life-care planning. Schedule some time with your loved ones to talk about your desired plans.
  • Include your physician in your conversation.
  • Put your wishes in writing by completing either the POA document or the Living Will document.
  • Make copies of your completed Advance Directive, and give copies to your loved ones or tell them where your Advance Directive document is located.  If you complete the POA form, then it will be very important to give a copy of that document to your appointed agent.
  • Give your physician a copy of your Advance Directive and ask her/him to place it in your medical record.
  • Remember that Advance Care Planning is a process and that it usually is ongoing.  You may decide to change your end-of-life-care plan at some point.  If you do, then it is important to complete the POA document or the Living Will document again, and to destroy any previous Advance Directive documents.  It is also important to give your physician a copy of the new document, and request that he or she place it in your medical record and remove the old document.
  • If you complete a POA, it is vitally important to maintain ongoing communication with your healthcare “agent” so that he or she can participate fully as your advocate in the event that you are no longer able to communicate your preferences. (The POA goes into effect only when you become unable to communicate your preferences or speak on your own behalf.)

Do you have an Advance Directive?


Advance Care Planning is the process of reflecting on, discussing  and planning for a time when, due to illness or injury, you cannot make your own medical decisions. This process is vitally important for the purpose of assisting your loved ones and your physician to provide you the best care when you cannot make your own decisions. Through this process you can create a plan. This plan is called an Advance Directive.  There are two main types of Advance Directives: the Durable Power of Attorney for Health Care, and the Living Will.  Both are legal documents.

  • Durable Power of Attorney for Health Care, also referred to as a “POA”:  A document that allows you to appoint another person, referred to as your healthcare  “agent” or “proxy,” to make medical decisions for you in the event that you are not able to make your own decisions and speak on your own behalf.  The POA also provides you with the opportunity to provide written instructions.  For most adults, the best way to document your plan is to use a POA form.
  • Living Will: A document which informs your physician, if you are near death from an incurable or irreversible illness or injury, that you wish to be allowed to die rather than be kept alive by life-prolonging measures that may postpone death but will not restore health.  There is no “agent” in a Living Will. If you have also completed a POA, then the POA will override your Living Will.