Planning My Way // For Care Near the End of Life

Care near the end of life can suddenly become complex and overwhelming, with no clear path as to what types of interventions (if any) are appropriate. There is only one person truly qualified to tell your health care providers how you feel about different issues—and that’s YOU.

Some people believe that doctors know best and therefore should make all the decisions. However, patients' values and goals are very important and should be the guiding force behind their care. Your health care providers have technical knowledge and years of experience, but without your help, they can't know what's best for you given your specific medical situation.

Two patients with the same condition can have very different ideas about what kind of treatment they want. Have you thought about what kinds of medical care you would choose if you couldn’t tell your providers what you wanted? Through advance care planning, you can help ensure that your wishes will guide future care.

The worksheets in this document will help you think about things, like:

  • Would or wouldn't you want life-sustaining treatments and when?
  • How do you want to spend your last days?

If life-sustaining treatments were the only way to keep you alive, would you want your doctors to use them? For some people, the answer is “Of course.” For other people, the answer is “Never.” For others, the answer would depend on the situation.

Through advance care planning, you can help ensure that your wishes will guide your future health care.

Advance care planning steps:

about what you would want if you had to make difficult choices.

about your views with your spokesperson, loved ones, and health care providers.

a spokesperson who can speak for you if you can't speak for yourself.

an advance directive to document your preferences.

a personal letter or audio or video recording to share your wishes.

Why Plan Ahead

Different people want different things. Consider Mr. Ruiz’s story

Carlos Ruiz has had severe heart disease for years. His doctor said, “Your heart is very weak, and it will keep getting weaker. Now we need to make some decisions about what you want for your care. One thing we could do is focus on supporting your heart, lungs, and other vital organs to extend your life for as long as possible. If you got sick, you would go to the hospital for treatment, possibly into the ICU (intensive care unit). If the treatment was successful, you would go home. But you would probably be weaker. The other thing we could do is make our top priority the relief of your shortness of breath and discomfort, even if it meant you might not live as long. Which of these options sounds right for you?

Mr. Ruiz said, “I’ve lived with this bad heart for a long time, but I’m not quite ready to give up. I’d like to try simple treatments, especially if I can receive them at home. I’d rather not leave my family and friends. I would prefer being comfortable at home. If you think going to the hospital would make a really big difference, I might consider it. But if going to the hospital only buys me a few extra days or weeks, I’d rather stay home, even if it means I don’t live as long.”

Choosing Your Spokesperson

A Durable Power of Attorney for Health Care document tells your health care providers who you want to make medical decisions for you if you get too sick to decide for yourself. It is included in most advance directive forms.

  • Why appoint a spokesperson? + -
  • Choosing your spokesperson + -
  • When choosing your spokesperson, consider Alice Roberts story + -

Do you want to appoint a spokesperson but aren't sure who that should be? The Choosing a Spokesperson worksheet can help you identify a competent adult who you feel would act upon your wishes.

Start Worksheet

Use this worksheet to discuss your choices regarding what would be important to you at the very end of your life.

Use this worksheet to communicate your preferences for burial and funeral arrangements.

Use this worksheet to communicate your preferences regarding organ donation to others.

Completing your Advance Directive

  • What is an advance directive? + -
  • Proxy Directives + -
  • Instructional directives + -
  • Which advance directive is right for me? + -
  • Which parts of the advance directive form should I complete? + -
  • How often should I review my advance directive? + -

To appoint a spokesperson and complete an advance directive, choose a legal document in your state from the list below. (Please enable popups for this link to work.)

Important Worksheets

After completing the worksheets "Choosing a Spokesperson" and "Completing your Advance Directive" you may consider some other worksheets.

Share your wishes regarding life-sustaining medical treatments that would keep you alive for a period of time but would not cure you or make you better.

Start Worksheet