Advance care planning is an ongoing process of talking about your health care goals, values, and wishes.
Calvary Hospital encourages you to discuss these topics with your family or friends in an ongoing dialog with those who represent you and your healthcare team.
It is important to have talks about your health care ideas, identify your goals, values, and wishes with your family and healthcare team. This conversation should be ongoing so that you have time and support to think through your options and identify what is most important to you when you think about your future health care in a number of common scenarios.
Having a plan in place before an event occurs is helpful for your family and medical team. In many common medical situations doctors need to make choices, sometimes quickly, when you are ill. Having your wishes clearly expressed will help your medical team make these decisions with the confidence that they are acting as you have wished and directed.
How to make your health care preferences known:
- Both patients and caregivers should have conversations about future care. These conversations should be part of your care planning process. These conversations should be had at every stage of treatment when living with a serious illness.
- By preparing for your future, you can ensure your wishes are given the utmost respect.
Below we have laid out some steps for implementing the advance care planning process. Calvary Hospital has put this list together to help patients and families start this important dialog.
- Identify a loved one who can make decisions.
- Will this person advocate for you to ensure you get the care you would want based on your expressed health care goals, values, and wishes?
- After you have defined your own values when defining what quality of life means to you and have identified a family member or friend who is willing and able to help you carry out your wishes.
- Plan a meeting with your health care provider.
- Discuss your ideas with your health care provider.
Completing advance directives
- Advanced directives are one way for you to make your wishes known about medical treatment before you need such care.
There are three kinds of advance directives:
- Health care proxy - This legal document allows you to appoint someone you trust to be your agent. The person you appoint makes health care choices for you only if you are unable to do so for yourself.
- Living Will - This form acts as a guideline for others, allowing you to tell people what treatments you would like to have and which ones you want to avoid in different health situations.
- Do-Not-Resuscitate - A do-not-resuscitate order (DNR) is a medical order written by a doctor. It instructs health care providers not to do cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. A DNR order is created, or set up before an emergency occurs.
The New York Health Care Proxy Law
The New York Health Care Proxy Law allows you to appoint someone you trust — for example, a family member or close friend – to make health care decisions for you if you lose the ability to make decisions yourself. By appointing a health care agent, you can make sure that health care providers follow your wishes.
Everyone over the age of 18 needs to appoint a health care agent. There are two situations in which a health care agent will be needed:
1. Temporary inability to make health care decisions – no matter what your age is.
- For example, you are having an outpatient surgical procedure and are under general anesthesia. Something unexpected happens and a health care decision needs to be made.
If you have a health care agent, since you are temporarily unable to make your own decisions, the health care agent may make the decision. Once you become conscious again, the health care agent would no longer have any authority to act;
2. Permanent inability to make health care decisions – this would arise if you were comatose from a terminal illness, in a persistent vegetative state, suffered from an illness that left you unable to communicate or, if elderly, suffered from senile dementia or Alzheimer's disease.
- Under these circumstances, you would obviously be unable to make your own health care decisions. If you don't have a health care agent, all appropriate medical treatments will be provided to you. If you have appointed a health care agent, your health care agent can be your voice and make your health care decisions according to your own wishes, or your best interests.
- Your agent can also decide how your wishes apply as your medical condition changes. Hospitals, doctors, and other healthcare providers must follow your agent's decisions as if they were your own. You may give the person you select as your health care agent as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones. You may also give your agent instructions that he or she has to follow. This form can also be used to document your wishes or instructions with regard to organ and/or tissue donation.
- Making decisions about how you want to live the remainder of your life and appointing the appropriate person to be your health care agent can be overwhelming. In order to assist in the decision-making process, the Department recommends the following steps:
Clarify Values and Beliefs
Choose a Spokesperson
- Choosing a health care agent who will speak for you and make decisions when you are unable is a very important task that each adult needs to make, regardless of age or health care status. Your agent will advocate for your preferred treatment and ensure that your wishes are carried out at a point in time when you cannot speak for yourself.
- Once your agent is chosen, it is very important to share your wishes, thoughts, and opinions about how you want to live the remainder of your life with your agent. A person will not be able to predict every scenario that may present itself in a healthcare situation. As such, explaining your thoughts, feelings and preferences will give your agent the information necessary to make decisions on your behalf.
Discuss Your Wishes
- Once your Health Care Proxy has been signed, it's important to ensure that a copy is given to your agent, primary care provider, and other family members. It is also a good idea to consider carrying a copy in your wallet or purse, in case of unexpected emergencies.
- Practical Issues - Compassion and Support at the End of Life
Forms: Appointing Your Health Care Agent in New York State
The New York Health Care Proxy form and instructions are available as an Abobe Acrobat PDF (portable document format) in the following languages: