We’ve summarized an alphabet’s worth of helpful information to help you navigate your way through advance care planning.
- Advance Directives
Advance directives are documents that outline what healthcare and treatment decisions should be made if you are unable to communicate these wishes. They can also identify who you would want to be your voice for your decisions if you are not able to communicate these directly. In Arizona, there are four types of documents that fall under this term: living will, health care power of attorney, mental health care power of attorney and a pre-hospital medical care directive (DNR). You can choose to complete one type of document or all four.
- Be Proactive
You cannot predict how, when or if you will become seriously ill or injured. COVID-19 has been a difficult reminder that even young, healthy people can have their health circumstances change in an instant. Be proactive and complete advance directives when there is time to think and discuss your choices with family, friends, associates and/or your healthcare team.
You have choices to make about your healthcare and treatment options, as well as choices on which advance directive documents to complete. By making choices now, you can alleviate the pressure on your family and trusted decision makers later. Advance directives are documents of choice and not limitations. No matter what your personal decisions are, it is important to document them.
- Do Not Resuscitate (DNR)
Do Not Resuscitate order is a licenses healthcare provider’s written order instructing emergency personnel not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest. A person with a valid DNR order will not receive CPR. Although a DNR order is written at the request of a person or his/her family, it must be signed by a licensed health care provider to be valid. In Arizona, a DNR is called a pre-hospital medical care directive. It must be on orange paper. This document is most often completed by those who have advanced illness or frailty and for whom CPR may be more damaging than therapeutic.
- End-of-Life Care
This refers to the healthcare and community services received toward the end of one’s life. Working with a palliative or hospice care team can provide supportive symptom(s) management services when curative treatment is not an option.
- Follow Up
Having a conversation with about your decisions and advance directives is great, documenting your choices is even better and registering them is the icing on the cake! And because these documents can be updated as your health and circumstances change, you will want to continue to follow up with them to ensure they continue to meet your healthcare preferences.
Should you need some guidance as to where to begin your advance care planning, you will find are many sources exist. You can speak with your healthcare provider, attorney, faith leader, family members or friends. Several resources to assist are available online, including on Heath Current’s Arizona Healthcare Directives Registry (AzHDR) webpage.
- Health Care Power of Attorney
One type of advance directive document that lets you choose another person, called an “agent,” to make healthcare decisions if you can no longer make those decisions for yourself. Unless the document includes specific limits, the agent will have broad authority to make any healthcare decision you would normally make for yourself. If you do not have a healthcare agent, then there is a specific list under state law as to who would make decisions for you.
- Informed Consent
Informed consent occurs when communication, that outlines the benefits and burdens of any treatment plan, between a patient and the healthcare provider results in the patient’s authorization or agreement to undergo a specific medical intervention.
You don’t need to be an expert in medical or legal jargon to complete your advance directives. Several forms and documents are written in plain language for all to understand.
You have heard that knowledge is power? Well, knowledge can also bring peace. By having your advance directives completed and registered, you and your family and trusted caregivers can have the peace of mind knowing your choices.
Having a conversation about advance care planning or end-of-life care isn’t always a conversation that people are excited to have. If your family members or friends want to talk with you about their preferences and wishes for end-of-life, LISTEN. It is a gift when you can engage with someone who is wanting to talk about their goals, fears and concerns. If it is too difficult to have the conversation, try to find someone who is comfortable with the conversation. This is an opportunity that shouldn’t be missed.
- Mental Health Care Power of Attorney
A document that allows and directs your chosen agent to make decisions for you regarding behavioral health placement and treatment if you no longer have capacity to do so yourself due to mental or physical illness. This can occur because of dementia or medication interactions or a mental health diagnosis.
Advance directives in the state of Arizona must be notarized or witnessed. While there are fees for service for notaries, most banks also have notaries available for their customers.
- Organ Donation
You can make your wishes about organ donation in your living will. This is important information for healthcare providers to know prior to the death of the patient.
Being prepared for the future is important when talking about finances, family and healthcare, no matter what the stage of life.
- Quality of Life
If you are seriously ill or injured or toward the end of your life, what do you want those final months, weeks, days to look like? Now think about those decisions being made by people who don’t know you or who don’t have the same priorities as you. By thinking about what is important to you, you can make choices that will lead to a good life and even a good death.
Just because you have completed advance directives and have registered them with the AzHDR, you may change your mind at any time. New documents can be prepared, and older documents revoked.
Students? Aren’t we talking about end-of-life decisions? Yes. If you are over the age of 18, you should have advance directives prepared. As life-long learners, we are students at life, at all stages in life. It’s important to consider our advance care plans during other stages in life besides just old age.
- Terminal Illness
A disease that is life-limiting, incurable and ultimately fatal. It is possible for people to live several years with a terminal condition.
If you are late to a lunch with a friend or family member, would they know what to order for you at a restaurant? How can you expect them to know your preferences about something as important as your health or end-of-life decisions? Eliminate the uncertainty by documenting your wishes and having a conversation with your trusted decision maker.
Do your values affect your daily decision making? By examining your values, you can make informed decisions about advance care planning. By documenting your choices that are influenced by your values, you can ensure that your treatment and care align with your values.
Advance directives in Arizona must be signed by EITHER a witness OR a notary. Please note that the witness must be at least 18 years of age, cannot be family member (related by blood, adoption or marriage), cannot be in your will to receive part of your estate, cannot be appointed as your representative and cannot be one of your healthcare providers.
An X-ray is a medical test that can look beneath the surface to see underlying conditions in your body. When thinking about advance care planning, things may not be right on the surface; you may need to examine your values and concerns before you can document your choices.
- Your Preferences
Advance care planning involves completing advance directives (documents such as a living will) and appointing a health care power of attorney (someone to make healthcare decisions for you if you are unable to speak for yourself). Then, most importantly, sharing your preferences and care wishes with your loved ones and/or associates.
While we know this is not an advance directives term, we appreciate your zealousness to get down to the letter Z as you learn more about the importance of advance care planning.