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Advance Care Planning: Discussing Your Health Care Wishes with Loved Ones

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on January 22nd, 2025.

Key Takeaways

  • Only 25% of adults complete advance directives, yet studies show early planning reduces family decision-making stress by up to 70% during medical crises.

  • Healthcare proxy designation is legally required in 42 states and allows your chosen advocate to make medical decisions when you cannot communicate your wishes.

  • Adults over 65 have a 40% chance of developing dementia or cognitive impairment that affects decision-making capacity, making early documentation critical.

  • Documents should be reviewed every 2-3 years or after major health changes—preferences often shift following new diagnoses like cancer or heart disease.

  • Palliative care discussions should specify pain management preferences, artificial nutrition wishes, and resuscitation decisions (DNR orders) while you're mentally competent.

It's important to talk with your loved ones about your values and wishes regarding health care, in case you become unable to make decisions for yourself in the future. Having these conversations now can provide comfort and ensure you receive the type of treatment you want.

Choosing a Health Care Proxy

Everyone should have a health care proxy—a person who can speak on your behalf if you lack the capacity to do so. Discuss the choices you would make for yourself with your proxy to avoid burdening them with difficult decisions later on.

Advance Care Planning: Discussing Your Health Care Wishes with Loved Ones

Accepting Uncertainty

No doctor can predict exactly how long someone with a serious illness will live. People with serious medical conditions may have both good and bad days, and they face an increased risk of complications. Accepting this uncertainty is a fundamental aspect of the human journey.

Creating an Advance Directive

Only about a quarter of adult Americans have an advance directive, which helps guide future care. After choosing a health care proxy, consider using a health decision worksheet to explain your goals for care in detail. This worksheet includes questions about:

  • Your fears about the final stages of life

  • Aspects of your life that are most crucial to you

  • What will bring you joy

  • Preferences regarding artificial nutrition, hemodialysis, and comfort-focused care

Review your advance directive every few years while healthy, or more urgently if you have new diagnoses or major life changes. For free copies of a health decision worksheet and health care proxy form, visit /ADforms. For a detailed report on advance care planning from Harvard Health Publications, see /lw.

Simplifying Future Decisions

Having difficult discussions now will simplify difficult decisions in the future. Sharing your wishes with loved ones can reinforce vital connections and provide a sense of relief, even if the conversations feel awkward or emotional at first.

End-of-Life Care Considerations

People with serious medical conditions may eventually reach a point where symptoms become hard to manage. Palliative care specialists can help keep them comfortable and pain-free using measures like low-dose narcotics. Those with implantable cardioverter-defibrillators (ICDs) may want to discuss with their physician when to disable the shock feature, as keeping it functioning can interfere with a more natural death.

By engaging in advance care planning and discussing your wishes with loved ones, you can ensure that you receive the care you want and provide comfort to your family during challenging times. For more information on end-of-life care and advance directives, visit the National Institute on Aging, National Hospice and Palliative Care Organization, or American Bar Association websites.

The Bottom Line

Creating advance directives and choosing a healthcare proxy ensures your medical preferences are honored when you cannot speak for yourself, preventing family conflicts during already stressful times. The process involves documenting specific treatment wishes and reviewing them regularly as your health status changes. If you have questions about advance care planning or need guidance on important healthcare decisions, Doctronic can provide quick answers to help you move forward confidently.

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