Create an advance directive to communicate your wishes for care at the end of life.
We may not like to think about it, but at any moment we could face a serious medical crisis – one that could leave us unable to communicate with our loved ones or health care providers. Yet, many of us haven't prepared for this possibility or formally communicated the kind of treatment desired if we were too ill to make those decisions for ourselves. This means that others would have to make these decisions for us without knowing for sure what we really want.
Formally communicating your wishes, known as advance care planning, takes care of those you love, as well as yourself. It involves setting up an advance directive, a legal document that describes your wishes for end-of-life care.
Four Steps to Advance Care Planning
Here are the four key steps for creating an advance directive:
- Think carefully about the type of care you would like to receive near the end of life and where you would like to receive that care.
- Discuss these wishes with your loved ones and doctors.
- Choose someone to be your health care agent (sometimes referred to as a health care proxy). This should be someone you trust to make decisions about your care if you become unable to.
- Put all of this in writing to formally document your wishes and share it with your loved ones, health care agent, and doctors.
Receive Help With Creating an Advance Directive
We encourage you to begin taking steps now to communicate your wishes. To get started, review Caring Conversations: Making your healthcare wishes known, a publication created by the Center for Practical Bioethics. It guides you through the process of creating an advance directive so your loved ones and doctors are aware of your wishes for end-of-life care. The booklet includes:
- The process of thinking about the type of end-of-life care you may want
- Guidance on how to talk to your family about these wishes
- Information about choosing a health care agent and what the agent's role is
- Two forms:
- A durable power of attorney for health care decisions
- A health care treatment directive form
While the kit includes forms, we suggest that you download state-specific versions of these forms to be sure they meet all of your state's requirements. In Massachusetts, this form is called a health care proxy form. It lets you name someone to make decisions about your medical care if you can no longer speak for yourself.
Other Resources on Advance
The Conversation Project
Access a "starter kit" to help you begin to identify and communicate how you want to live at the end of your life. Visit The Conversation Project Website
National HealthCare Decisions Day
The Conversation Project hosts a video presentation called Imagine that gives an overview of advance care planning and why it's so important. (Scroll down the home page to find the link to the Imagine video.) Watch the Video
Take advantage of free resources such as brochures, advance directive forms, and instructions for each state. You can also check out this video on advance care planning that helps explain the benefits. Get Free Resources
American Hospital Association
Get answers to questions about advance directives compiled by the American Hospital Association in their Put It in Writing brochure. Download Brochure
Medical Orders for Life-Sustaining Treatment (MOLST)
MOLST is a Massachusetts program designed to improve the quality of care patients receive at the end of life. Doctors and patients can use the MOLST medical orders form to document patient preferences about the types of life-sustaining medical treatments the patient would like to avoid or receive. These medical orders can be honored by health professionals across care settings – such as at home, in a hospital, or nursing home.
The MOLST medical orders form can be used to supplement a personal wishes statement. The difference is that the MOLST form is authorized by law in Massachusetts, while the personal wishes statement is not. The Massachusetts MOLST form may be honored in some states outside of Massachusetts, but not all. Other states may also have their own MOLST forms. Learn More About MOLST