What is Healthcare Planning or Advance Care Planning?
Healthcare Planning is about taking control of your healthcare wishes so your goals, values and preferences are known and can be respected by health providers and those closest to you.
It is one of the most important discussions about your health you can have.
It involves thinking about, discussing, and typically documenting your goals and the types of healthcare you may or may not wish to receive. It also involves designating someone to speak for you if you are unable to speak for yourself.
I feel great! Why should I do this now?
The ideal time to have advance care planning discussions is when you are feeling well – just like financial planning, which works best when done years in advance of retirement. The earlier you plan, ideally before you reach a health crisis, the more you will benefit.
The American College of Physicians ask that patients undergo advance care planning, also known as Advance Care Planning, anytime a new chronic condition is diagnosed or there is a significant event or change in your life such as a hospital stay. The American Bar Association recommends reviewing your decisions when any of the following “5 D’s” occurs: Death of a family or friend, Divorce, receive a new Diagnosis, experience a significant Decline in health or reach a new Decade.
Can ACP be done for children and young adults?
Advance care planning should be completed by a person who is authorized to consent to medical decisions. Typically, that is an adult. Each state defines minor consent differently.
The Iris Empower program is only for individuals 18 and older to create their own advance directives. If you are under 18, Iris recommends speaking to your physician about your advance care planning needs.
Questions about the benefits of ACP
How does ACP allow me to get the care I want?
ACP is all about you having a voice in your future care. Through the conversation you will get to say what kind of care you want and then create legal documents that ensure your doctors honor your wishes. Studies demonstrate advance care planning helps patients get the care they want. A study of 3,500+ patients published in the New England Journal of Medicine concluded that performing this type of planning and having Advance Directives on file at the doctor’s office and/or hospital was strongly associated with patients receiving the care they wanted. The study also concluded that more than one quarter of elderly patients need a surrogate decision maker during advanced illness.
How does ACP improve my quality of care?
ACP protects you from receiving unwanted or unnecessary medical interventions and lets you get just the kind of care you want. There is strong evidence that this kind of planning improves the experience of care for both the patient and their caregivers / family. One study published in the Journal of the American Geriatrics Society was conducted to determine whether Advance Care Planning affected quality of care for 4,000+ people. Patients had higher satisfaction with their care, especially the communication and decision making aspects. Healthcare planning was shown to reduce hospitalization time and increased participation in hospice.
How does ACP help me live longer?
ACP lets you voice your wishes for care and thus reduces stress in both you and your caregivers or loved ones. Less stress and improved quality of care can have very positive effects on your health. Studies have demonstrated advance care planning helps patients live longer. One study published in the New England Journal of Medicine of patients diagnosed with lung cancer demonstrated that early palliative care, of which advance care planning is the main component, was associated with 25% longer patient survival times.
I already have a living will, DNR, or other documents: why do I need this service?
Creating these documents without the support of a trained healthcare facilitator can be like baking a cake without a recipe. The value of the plan is only as high as the quality of the thought and discussion that went into creating it. Healthcare planning is all about having high quality discussions with trained facilitators, leading to high quality decisions and documented plans.
Many of the people who already had documents in place, but worked with us decided to make changes or add others to the conversation. We regularly find that decisions change as health conditions evolve. We ensure documents remain current and check in often to distribute these important documents at your direction to family, doctors and hospitals.
Questions about Advance Directive forms
What is the difference between medical power of attorney and durable power of attorney?
A durable power of attorney addresses your wishes related to who you would like to make decisions for your personal property if you are unable. A medical power of attorney addresses your wishes related to who can speak on your behalf for medical decisions if you are unable. Both are important.
A medical power of attorney only goes into effect if you are unable to speak for yourself. A medical power of attorney’s role is to relay your wishes to healthcare providers, not their wishes for your care.
What is the difference between medical power and a living will?
A medical power of attorney allows you to name someone you trust to make medical decisions on your behalf if you are unable to speak for yourself. A living will (also known as a directive to physicians), can include a medical power of attorney, but goes into detail about your specific wishes about treatment in the event of serious illness. Both of these forms are specific to your state of residence.
What if I change my mind or my situation changes? Can I update these forms? I feel like I won’t know what I think until I’m in that situation.
Absolutely! You remain in control. You can make changes to these as often as you like. Your plan of care remains flexible and your wishes should be communicated to healthcare providers every time you are admitted to a healthcare facility and at least annually with your primary care provider.
What do I do if I am not sure how to answer a question?
Iris recommends speaking with your doctor or healthcare provider to help you determine the right choice for you.
Questions related to my healthcare team
Will healthcare providers/doctors, hospitals, and nursing homes respect my choices, once I complete these documents?
Healthcare providers have a duty to respect your wishes when providing your care, and there is good evidence that communication of your thoughts to family and healthcare providers is essential to ensuring your care is carried out based on your wishes. Without this personal information, decisions can easily result in providers focusing on standardized medical protocols instead of your particular needs.
Questions related to my family
I don’t want to add one more thing to my family’s “to do” list. How does ACP reduce the stress on my caregiver, family, or loved ones?
If there were ever a situation where you couldn’t make clear your wishes, it can be very stressful for your loved ones to try to figure out what they should do for you or instruct a doctor to do for you. Sometimes, if one’s wishes are unknown, there can be conflict among different members of the family over what’s the best thing to do. ACP allows for everyone to be on the same page about what you want for your care.
I’m worried about doing this because my family has discussed this before and we don’t agree. What should I do? What if they try to stop my plan and I can’t speak for myself?
It is extremely important to have ACP sessions, especially if you know there is already disagreement between family members. Iris facilitators are skilled in helping family’s resolve differences in opinion about care choices. Healthcare providers have a legal and ethical duty to respect your wishes when documentation of your wishes is present. Having this documentation available when you receive care reduces conflict between family and helps to ensure your wishes are respected.
Questions about accessing my account
I forgot my password. How do I reset it?
If you have forgotten your password, click the “Forgot your password?” link under the sign in form.