Advance directives: Plan for the unexpected

An advance directive is a legal document that provides medical decisions when a person is unable to communicate because of an injury or illness.

Imagine you were in a serious car accident and unable to speak for yourself. Who would speak for you? Who would make needed medical decisions while you were unable to communicate?

It’s a scenario none of us expects to be in, yet it happens every day. Preparing for a moment like this is easier than you might think.

What is Advance Care Planning?

Advance care planning is a process that helps you think about your health care goals and values; consider health care choices that may have to be made in the future; talk about your choices with your health care provider and those close to you.

Advance care planning is increasingly being viewed as a public health issue, given its potential to prevent unnecessary suffering and support an individual’s health care decisions and preferences.

At this time, the CDC said 70% of Americans do not have an advance care plan in place.

‘Planning ahead’ starts with a conversation

Completing an advance directive is the end of a process that begins as a conversation with loved ones. You should talk with loved ones about questions like:

• What makes a good day for me and whom would I spend it with?
• Whom do I want to speak for me if I can’t speak for myself?
• Have past experiences shaped my feelings about the treatment I would want in that situation?
• How do I define quality of life?

These questions help you outline your values and fill out your advance directive.

“The process of completing the paperwork gets families talking about these important but sometimes difficult or awkward topics,” said Dr. Ning Zhou, a hospitalist and medical director with Marshfield Clinic Health System. “Many families come out of this process with a better understanding of each other by having that shared conversation.”

Fill out an advance directive

Everyone 18 and older should have an advance directive.

It’s really important for Wisconsin residents to have an advance directive in place because Wisconsin is not a next-of-kin state. This means if you experience an illness or injury that leaves you unable to communicate, family members cannot make health care decisions for you unless you have specified a health care agent in an advance directive.

Advance directives allow you to:

• Name a person who can make health care decisions for you if you became unable to make your own decisions.
• Express your wishes for medical treatment options.
• Prepare final thoughts and feelings should your illness or injury be life-threatening.
• Request special ceremonies or traditions you would like carried out.
• Communicate wishes for post-death care of your body.

“Having a completed advance directive is essential when a patient is unable to make his or her own medical decisions,” said Dr. Zhou. “When we don’t know who to turn to, we may not understand what’s important to a patient or how to best respect a patient’s wishes.”

The default approach for patients who cannot speak for themselves is to do everything possible for them treatment-wise. However, some patients wish to be made comfortable rather than extensively treated, but without someone to speak for them, they cannot express that wish.

“The best way for patients to make sure their wishes and values are respected is to take the time, when there is not a crisis, to complete the advance directive paperwork,” he said.

Start the advance care planning process with Marshfield Clinic Health System

Learn more about advance directives Download an advance directive document