Advance care plan puts you in control

Don't leave the decisions up to others Being in control of your life is the American way - we are self-made, self-reliant people who covet our independence. But age or illness can rob us of the chance to make our own choices about health care. Without explicit directions about how you want health care and end-of-life issues handled, if you are incapacitated and unable to make your choices known, the burden of these decisions will fall to your family. An advance care plan gives you a choice to make your wishes known, even if you are unable to communicate. While putting together your plan and discussing it with family members may be emotional, it's one of those things, like making a will, that will give you peace of mind. Having a plan in place also makes it easier on your loved ones, since they will know they are carrying out your wishes. Your plan will ensure that your care is customized to reflect your personal preferences and health needs, as well as your social, cultural and religious requirements. As part of its educational materials developed for heart failure patients, the Heart Failure Society of America has compiled a booklet explaining advance care planning that is helpful not only to those with a chronic condition such as heart failure, but also for others who may be thinking about their future. The booklet explains that an advance care plan may include some or all of these documents: An advance care directive. This document should provide clear evidence of your wishes regarding treatment and can include a living will, a durable health care power of attorney and a statement about organ donation. A do-not-resuscitate order. This directive, made by you or your family in consultation with the doctor, tells doctors, nurses and other rescue personnel what they should or should not do when a person stops breathing or when their heart beats so irregularly as to threaten life or stops beating entirely. A do-not-resuscitate order can include instructions on whether to use different types of methods to revive a person. A living will. This legal document lets a person who is unable to participate in decisions about their medical care to express their wishes about life-sustaining treatment. A living will is usually used during a terminal illness when a person is unable to communicate; it lets you set limits on what is done to you regarding the use of medical treatments such as CPR, blood transfusions, mechanical breathing, surgery, antibiotics, kidney dialysis and invasive measures to provide nutrition and fluids. A health care power of attorney. This allows someone you designate to make all health care decisions for you, including the decision to refuse life-sustaining treatment if you are unable to make the decision for yourself. You can give someone a general power of attorney or you can limit their decision making to certain issues by including instructions about your care. For example, you can specify preferences regarding particular treatments such as tube feeding, intravenous fluids and organ donation if you have not covered those subjects in a living will. A financial plan. You and your family may have concerns about paying for medicines, doctor and hospital bills and other types of health care. A financial plan can help you deal with these issues and also provide for your family. Talk to your doctor, nurse or hospital about where to get information about advance care planning as well as discuss various health care options with you. You may also wish to consult a lawyer to help you ensure that your plan meets your individual wishes and state legal requirements. And be sure your family knows and understands your wishes for care. Discussing these issues now will make implementing them easier when that becomes necessary. To learn more about advance care planning visit the Heart Failure Society of America patient education website, http://www.hfsa.org www.hfsa.org. - ARA