Hospice AtlantiCare: Advice About Planning End-of-Life Care

“Death is a difficult subject for most people. It’s not a happy subject, but it doesn’t need to be dreadful – and it’s important to talk about your wishes for end-of-life care,” Deborah Bayer, DO, medical director for Palliative Care and Hospice AtlantiCare, said.
Over the course of a career in medicine, Bayer says, she has repeatedly experienced the importance of advance care planning.
“Creating an advance directive, such as a living will, or naming a healthcare proxy helps your family and loved ones know what kind of care you want at the end of life. Putting these wishes in writing will take the burden off your family when the time comes – sparing them the anxiety of guessing about how to best handle your medical care, knowing that they are respecting your wishes,” she said.
Advance directives come in several forms, and serve different purposes, Bayer explains.
• A living will establishes and records which life-sustaining treatments you do or do not want, and can establish goals for medical care.
• A Durable Power of Attorney names a person who will make healthcare decisions in your stead, in the event that you are unable to make decisions for yourself.
POLST (Practitioner Orders for Life Sustaining Treatment) is a doctor-designed form detailing your wishes for life-sustaining treatment and establishing goals for medical care.
A POLST is a medical order, which a physician or advanced practice nurse writes in collaboration with a patient or the durable power of attorney and, once completed, becomes part of your medical record.

“All adults should have a living will and a Durable Power of Attorney. Putting your wishes in writing before a medical event or illness means that your family will have this document to fall back on…Think of an advance directive as an insurance policy.”

POLST forms are intended for people who are approaching the end of life – older adults or persons living with a terminal illness. “Talk with your healthcare provider if you think a POLST form would help you,” she recommends.
Of course, the conversations that lead up to this kind of planning can be touchy or emotional. “Don’t think you need to rush through it.” Bayer suggests having a series of conversations, starting with broader topics, such as what goals or milestones you would like to reach or achieve – paint a picture of your ideal “golden years.”
According to a 2013 survey, 90 percent of people think that talking with loved ones about end of life care is important, but only 27 percent have actually had the conversation. “Talking about your wishes for end of life medical care is tremendously important. Your return on investment – having a plan in place that makes your wishes known and relieving the burden of decision making from family – is well worth the energy,” says Bayer.

For more information on advance directives, visit AtlantiCareWell4Life.org or call the AtlantiCare Access Center at (888) 569-1000.

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