Have the conversation: April 16 is National Healthcare Decisions Day

Talking about the end of your life is not comfortable.

But it’s a conversation worth having to make sure your loved ones or health professionals know what you want to happen to you when you aren’t able to speak for yourself.

April 16 is National Healthcare Decisions Day, a day to make, discuss and document future healthcare wishes and decisions in your advance care planning, also known as advance directives. Meritus Health offers free guidance and documents to help with this planning, be it for yourself or someone in your care.

What is an advance directive?

An advance directive is a legal document that provides instructions for end-of-life care and spells out whether life-sustaining treatment should be withdrawn or withheld when a person is dying or permanently unconscious.

Susan Lyons, nurse practitioner and supervisor of supportive and palliative care at Meritus Medical Center, views advance directives as “if-then” documents.

“If I’m in a terminal condition and cannot speak for myself, then these are the medical treatments I do or do not desire,” Lyons explained. She said these legal documents are important and often overlooked.  All adults should consider documenting their wishes, regardless of health or age.

When should I start the conversation about advance directives?

Start the conversation now, she said. The best time to complete an advance directive is when you’re healthy and the discussion is neutral or removed from an illness or devastating medical condition. An appropriate time might be when a family member or friend has experienced a life-changing or life-ending event.

Use a blank advance directive form as a conversation guide with your family or doctor. Online advance planning forms are available at https://www.meritushealth.com/files/adirective.pdf.

Who is in charge of my advance directives?

Appoint a health care agent or power of attorney, Lyons said. The first part of the advance directive allows you to indicate a medical proxy, the person you choose to make health care decisions when you cannot.

Select someone who understands your values, stays calm in crisis situations and speaks up to ask difficult questions.

What is a living will?

Define what matters to you the most, Lyons said. The second part of the advance directive is called the living will and it offers an opportunity to discuss what you value at the end of life.

The document “speaks” for you when you cannot speak for yourself if you ever have a serious medical condition that physicians believe is not survivable.

“The living will allows you to tell us what your wishes are about certain mechanical or artificial means of support,” Lyons said. “A lot of people have really strong feelings about things like breathing machines and feeding tubes.”

The document also allows you to dictate whether you want the support of a hospital-based medical team, or if you’d prefer to die at home with your beloved pet by your side.

If you wish to die in your own home, an advance directive may eliminate unwanted hospitalizations, but fulfilling that wish requires the support of a home hospice agency and round-the-clock supervision by family and/or friends. Talk about who would be a part of a “home care support team.”

When do advance directives become valid?

Sign the advance directive and share it, Lyons said. An advance directive becomes legally valid when you sign the document. However, it typically goes into effect when the doctor in charge of your care decides that you have lost the ability to make informed decisions about your health care.

In Maryland, the document must be witnessed by two individuals, but it does not require a notarized signature or the involvement of an attorney.

After completing the advance directive, give a signed copy to your family and friends who will be involved in your care, your health care agent and your primary care physician.

Decisions about end-of-life care are deeply personal and emotional, but starting a conversation and putting forth your wishes now will create peace at a time when it’s needed the most.

To learn more about advance directives or to find related documents, go to https://www.meritushealth.com/about/patients-visitors/advance-directives.