Frequently Asked Questions About Advance Care Planning

Is there a right time to make an Advance Care Plan?

Yes. Now. Everyone over the age of 18 should have a plan in place regarding their heath care choices for future health care conditions. We encourage the conversations, decisions and plans to take place before a health care crisis occurs.

Who are some possible health care agents I can choose?

Think of a spouse or partner, a parent, a sibling, a child, a best friend. Whoever you decide to chose, make sure you have a discussion with this person and ensure they are willing to take on that roll as well as honor your choices and wishes.

When is the right time to have a discussion about Advance Care Planning?

Anytime is the right time as long as you have your chosen health care agent and whoever you want to know your wishes at the table. Holidays are a good time – most families are together. Family reunions are another great option!

Are there any major medical considerations I need to take into account when making my plan?

You always want to consider your current state of health when making a plan. Do you have CHF or COPD or cancer? These can play a big factor in your decisions and wishes.

How often should I update my plan?

We suggest looking at your plan at least every five years, or every time your current health state changes.

What is POLST?

POLST is a medical order obtained from and signed by the person’s physician. It is a set of standard patient care protocols, to be followed by emergency medical services (EMS) personnel. These emphasize that the patient will receive palliative and supportive care, but no resuscitative measures.

Should I be talking to my doctor about a POLST?

A POLST form is most appropriate for seriously ill persons with life-limiting, also called terminal, illnesses or advanced frailty characterized by significant weakness and extreme difficulty with personal care activities.

How can I start a conversation with my family about these issues?

Plan for yourself first and let your family know what you want. Tell them you don’t want them feeling the burden of making the decisions for you. Then, ask them to tell you what they want.

What should I say during a conversation with my loved ones?

  1. Who would make decisions for you and how they would make these decisions? Make sure whoever you choose to represent you not only knows what you want, but is able to make complex decisions in difficult situations.
  2. Consider what your goals for medical treatment would be if you had a serious, permanent injury to your brain. How bad would such an injury be for you to say, “Don’t use medical treatments to keep my alive in that state.” Many people simply say, “Don’t keep me alive if I am a vegetable.” If you feel that way, can you describe what it means to you to be a “vegetable?”

Should I be talking with my doctor about my plan?

When possible, it is important for you to talk to your physician to make sure planning is clear, complete and will be supported by your health care provider.

What is an Advance Directive?

An Advance Directive is a plan, indicating preference for future health care decisions if a person is unable to make decisions. It is generally a written document. It is a legal document, such a Living Will or a Durable Power of Attorney for Healthcare.

What is a Living Will?

A Living Will is a written document that is signed, dated and witnessed. It contains instructions that tell physicians and family members what life-sustaining treatment one does or does not want at some future time if a person becomes unable to make decisions.

What is a Durable Power of Attorney (DOA) for Health care?

A DOA is a legal document in which a person (a principal) appoints someone else (an agent) to make his/her decisions in the event he/she becomes incapable of making decisions.

Also known as:

  • Healthcare Agent
  • Healthcare Proxy
  • Healthcare Surrogate

Does Providence St. Patrick Hospital offer an Advance Directive form?

Yes. The Five Wishes® Advance Directive booklet is St. Patrick Hospital's tool of choice used by the Advance Care Planning Facilitators to help patients with their completion of Advance Directives.

What is the Five Wishes® Advance Directive?

The Five Wishes® Advance Directive tool is a comprehensive and holistic Advance Directive tool. It includes the three specific considerations of Advance Directives consistent with Montana law. It is also in compliance with the legal statutes about Advance Directives in 42 states. The Five Wishes tool is structured to help a person designate an Advance Care Plan with respect to their treatment choices inclusive of their personal, social, economic, emotional and spiritual concerns.

What Quality of Life issues are addressed in the Five Wishes® Advance Directive?

If you were very sick and near the end of your life, what would be the most important for you?

  • To be surrounded by your family and loved ones.
  • To be in your own home, if possible.
  • To avoid pain.
  • To have people praying for or with you.
  • To express love and forgiveness to others.
  • To receive love and forgiveness in return.

How does Advance Care Planning and implementing an Advance Directive improve End of Life Care?

A “good death” may be defined as one that is free from avoidable distress and suffering for patients, families and caregivers. It can be described as in general accord with the patient's and family's wishes and reasonably consistent with clinical, cultural and ethical standards. (“Respecting Choices”)

Who should get copies of my Advance Directive?

  • Each health care agent named
  • Primary care physicians
  • Any specialty physicians
  • Health system of choice (Hospital)
  • Extra copy for yourself

What is Palliative Care?

"The goal of palliative care is to prevent and relieve suffering and support the best quality of life for patients and their families, regardless of the stage of the disease or the need for other therapies. Palliative care is both a philosophy of care and an organized, highly-structured system for delivering care. Palliative care expands traditional disease-model medical treatments to include the goals of enhancing quality of life for patient and family, optimizing function, helping with decision making and providing opportunities for personal growth. As such, it can be delivered concurrently with life-prolonging care or as the main focus of care.”

- Dr. Diane Meier, the National Center to Advance Palliative Care, excerpt from her book, Palliative Care – Transforming the Care of Serious Illness.