Advanced Care Planning and Decision Making

Making decisions about you treatment can be overwhelming. It is important for you and your family to have a good understanding of all of your options, but sometimes the information provided can be complex or confusing. Social workers can help patients and families during the treatment decision-making process by facilitating communication with the doctor, making sure patients understand their options, helping patients process their options, arranging and facilitating family meetings, and advocating for patients based on the decisions they make.

Patients are often asked to think about future medical decisions in addition to decisions about their immediate care. This is referred to as advanced care planning. Sharing your wishes about future medical intervention can help guide your family and care providers in a crisis and ensure that your values and goals are respected if you are unable to speak for yourself. There are several ways that you can share your wishes about medical care. Some options are outlined below.

Use a Health Care Proxy form to choose someone you trust to make medical decisions on your behalf if you were ever unable to make decisions yourself – for example, if you were unconscious, or temporarily or permanently incapacitated. Having a health care proxy on file helps your providers know who to talk to in these situations. In a Health Care Proxy, you can also give your health care spokesperson written directions about any treatments you do or don’t want.

A Living Will records your wishes for how you would like to be treated specifically at the end of your life. Many people choose to have both a Health Care Proxy and a Living Will. You don’t need to consult with a doctor to use either of these two tools.

You may not know all the different kinds of treatment that a hospital might use toward the end of your life. Use a MOLST (Medical Order for Life-Sustaining Treatment) to learn directly from your doctor about life support options, such as feeding and breathing tubes. If you decide that you want to complete a MOLST, both you and your doctor need to sign it because it goes directly into your hospital chart like any other doctor’s order.

If you decide that you do not want to receive CPR, a Non-Hospital Do-Not-Resuscitate (DNR) Order ensures that ambulance personnel will honor your wishes. These wishes can also be documented on a MOLST form.

You can also plan ahead for someone you trust to make financial decisions on your behalf. A Power of Attorney can be tailored to suit your needs and preferences.

You don’t have to consult a lawyer to use any of these tools, but lawyers can answer many questions and help ensure that your advance planning accomplishes your personal goals. Roswell Park offers free legal guidance through our LegalCare Program.