of us hope and anticipate that we will always be able to speak for
ourselves and make our own decisions. However, if you were to
become very seriously ill or injured and not able to communicate,
who would speak for you? Who would make decisions about your
healthcare? How would your healthcare team know what you wanted in
the way of medical treatment?
Planning Ahead Can Be a Gift
An advance care plan can be a gift you give yourself and your
family. A plan gives you the opportunity to provide your loved ones
peace of mind that they will know what to do on your behalf should
the need arise. While many of us do not think we will ever need a
plan, too often the lack of one can result in questions, confusion,
and disagreements on the part of family members trying to envision
what you would want. A plan relieves them from having to guess
whether they did the "right thing." A plan also helps your
healthcare team make treatment decisions that reflect your
preferences and values.
Think, Decide, Communicate, and Document
Healthcare Decisions Day is recognized on April 16th each year
to inspire, educate, and empower the public and providers about the
importance of advance care planning.
Advance care planning is not difficult but it does involve
having thoughtful conversations with close family members or other
loved ones about your care wishes and preferences, and documenting
those preferences in writing through an instrument such as an
advance directive or living will. Among the decisions to be made
and documented is the name of the individual you have chosen to
serve as your "healthcare proxy," or the person who will be
responsible for making decisions for you on your behalf if the need
arises. This person is someone you trust to help ensure that your
wishes are honored and carried out.
A Lack of Planning Has Economic Consequences
At times, a lack of advance care planning results in unintended
and unnecessary medical expenditures. Most terminally ill people
would prefer to die at home, with family members and other loved
ones present. However, the experiences of most seriously ill and
dying are the opposite of what Americans say they want. About
two-thirds of Americans die in institutions such as hospitals and
nursing homes, and many spend extended periods in intensive care
settings. This reality often translates into substantial
expenditures by individuals and their family members for medical
treatment that the individual may not have wanted.
A lack of advance care planning, coupled with our rapidly aging
society, also has a tremendous effect on our nation’s healthcare
resources. More than 25% of all Medicare expenditures are for care
during the last year of life. This is true despite the fact that
many Americans have expressed preferences for “no heroic measures”
when faced with a terminal condition. Documenting in writing what
you would want and sharing your plan with your family, other loved
ones, and healthcare providers helps to ensure that your wishes
will be honored and carried out.
Where You Can Go for More Information
CDC's On-Line Course
Professionals in the public health and aging networks are in
unique positions to help educate the public on the role and value
of advance care planning. CDC now offers an on-line
course especially for this audience. The course is free of
charge and offers continuing education credits.
Many materials are available to help people better understand
the value of advance care planning and how to complete a plan.
Learn more about resources on advance care planning and related
topics such as hospice, palliative care, caregiving, cognitive
impairment, and relevant legal issues. While the list of resources
is not exhaustive, it represents a variety of materials that you
should find helpful, including tool kits, sample plans, and
Learn more about National Healthcare Decisions Day and watch a
video highlighting the value of advance care planning.