Planning is a key part of our lives, whether we are purchasing a new house, sending a child to college, or saving up for retirement. Planning ahead is a way we look to enhance some aspect of our future lives. With so many different parts of the future to plan for, some may get overlooked or set aside to manage later. Advance care planning is one of these facets of future planning that can easily get glossed over. However, it is important to have conversations about the future with family members and plan now instead of later.

What is Advance Care Planning?

signing paperwork

Advance care planning involves different types of decisions you may have to make for the future regarding your personal health care and letting others, such as your family and medical team, know about your choices (Advance Care Planning, n.d.). This is important in cases of a potential future medical crisis that can leave you unable to make your own health care decisions. Keep in mind that the purpose of advance care planning is to have your future health care decisions known in the event that you cannot express them yourself. You must properly document these decisions in order to ensure that your health care decisions are honored. Your choices are specific to you and should be made to fit your situation.

Advance care planning can also give your loved ones peace-of-mind, minimize stress, and reduce potential family conflicts (Benefits of Advance Directives, n.d.). If your wishes and decisions for emergency or end-of-life care are not known, it can cause more stress for your loved ones to have to make those decisions on your behalf. Additionally, if some family members do not agree with the decisions being made for you, conflicts may arise. Therefore, it is important to start thinking and planning for the future now.

Advance Care Planning Decisions

Some advance care planning decisions cover choices made regarding the use of emergency treatments to keep you alive. Examples of these include (Advance Care Planning, n.d.):

  • Cardiopulmonary resuscitation (CPR)
    • Restores heartbeat if the heart stops. Involves putting air into the lungs by pushing on the chest. Electric shocks and medications may also be involved.
  • Ventilator use
    • Ventilators are machines that help you breathe. A tube is put through the throat into the windpipe to get air into the lungs. This is often uncomfortable, so medications keep you sedated while on a ventilator.
  • iv fluidTube Feeding and intravenous therapy (IV) use for fluids
    • If you are unable to eat, a feeding tube may be placed through your nose down to your stomach.
    • If you are unable to drink, you may be given fluids through an IV. These fluids are delivered through a thin plastic tube that gets inserted into a vein.
  • Hospice Care
    • At the end of life, hospice care works to sooth and relieve suffering.
    • This can include options for reduced medical testing, spiritual counseling, and pain medications.
    • Hospice care is different from palliative care. Both types of care focuses on providing relief and comfort for the patient and their family. However, palliative care can be used at any stage of a serious illness, and can be provided together with treatment, whereas hospice is typically used after treatment has ended.

Advance Care Planning Documents

There are various documents involved in advance care planning. All of your wishes and decisions will be kept in your advance directive and supplemented by your living will and durable power of attorney for health care. There are also additional documents you can consider, including a Do Not Resuscitate Order, Non-Hospital Do Not Resuscitate Order, Do Not Intubate Order, and Organ and Tissue Donation. Some of these documents may include overlapping information or may not apply to you. Ask your primary care physician if you have questions regarding specific documents listed here or which ones are necessary for you and your situation (Advance Care Planning, n.d.):

Advance Care Directive

  • This legal document goes into effect only if you are incapacitated or unable to speak for yourself and allows others to know what kind of medical care you want. Other documents, the living will and durable power of attorney for health care, mentioned below, supplement your advance directive and detail your wishes to either your doctors or designated health care proxy. This can also include your wishes regarding end-of-life care.
  • This document can be adjusted at any time as your situation or health changes.
  • The state of California has an Advance Directive Registry where a copy of your advance directive can be found in the event that you cannot provide one.
  • Your signature on the document must be notarized or witnessed by two adults who are unrelated to you or work at a health care facility in which you may reside in order to make the document legal (California Advance Directive, n.d.).
  • You can find blank forms on your state government website.
  • You can also include the following documents with your advance directive in order to include additional decisions of yours. These include:
    1. Living Will
      • This document tells your doctors how you want to be treated in the event that you are dying or permanently unconscious.
      • Some of these decisions include:
        • Do you value having the most days of life possible?
        • Do you value quality of life over days of life?
        • What would you want if an illness leaves you in a permanent coma?
    2. Durable Power of Attorney for Health Care
      • This legal document names a health care proxy, or someone who will made medical decisions for you when you are not able to.
      • Your health care proxy should understand your values and wishes from your advance directive so he or she can made medical decisions for you, in the event that you cannot make those decisions yourself.

Tools to Support Advanced Care Planning

Advance care planning can be an intimidating task. There are a variety of things to consider and it can be difficult to figure out where to start. Here are a few things to keep in mind while thinking and planning for your future health care (Advance Care Planning, n.d.):

  • Personal Values Matter
    • Your personal values play a large part in the advance care planning process and your health care decisions will be made with these values in mind.
    • These values are similar to the information included in your living will. For instance, is your primary focus quality life over quantity of living days? Other values include choices about the type of care you do or do not want such as ventilator use, dialysis, and other medical testing or procedures.
  • Talk to Your Doctor
    • You can ask your doctor how your current health conditions may influence your health in the future.
    • If you do not currently have any health conditions, but have a family history of medical issues, ask your doctor how developing family health problems can impact your future.
    • Your doctor can help you understand your choices and options before putting them in writing.
      • Discussing advance care planning decisions with your doctor is free through Medicare during your annual appointment.
      • Private health insurance may also cover these conversations.
    • Palliative care program is an additional resource you can turn to that can help you understand your options and fit those options into your personal goals.
  • Fill Out the Forms
    • Once you have thought about your personal values and talked to your doctor about health conditions and health care options, you should house your decisions in their respective documents and forms.
    • A lawyer can help you through this process but is not required. Your lawyer will not know all of your medical treatments, so talking with your doctor may be more helpful.
    • In California, forms for your Advance Directive, Living Will, and Durable Power of Attorney for Health Care can be found here:
  • Share Your Wishes
    • It is important to inform your loved ones and doctors of your health care wishes. These decisions can be followed to provide the kind of health care you chose in the event of a medical emergency or end-of-life situation where you cannot voice those decisions yourself.
    • Share any important documents that detail your choices with your health care proxy and doctor. Tell close friends or family where you keep a copy.
    • Sharing your wishes and having conversations about end-of-life care can be difficult. These conversations can be done during a family meeting. Having your documents on hand can help. Here are additional resources to help you navigate these difficult conversations:
      • Five Wishes provides documents to house all personal, medical and legal documents and guides to help you navigate conversations during the advance care planning process. This resource can help you think about the decisions you will have to make and share those decisions with your loved ones.
      • The Conversation Project has resources to help guide you through the planning and sharing process.

Call To Action

The future is unpredictable, but we can plan now to make the future a little less stressful.

Planning now for your health care future can help minimize family strain and disagreements regarding decisions surrounding your care, to make sure the care you receive is what you wanted.

While having conversations about end-of-life care or making decisions for the future may be uncomfortable, it is important to make these decisions now. Understanding and exploring the different advance care planning options and making the best decisions for yourself can leave you confident in your choices for your future. If you haven’t started planning for your future, it is not too late to start.

Here are the resources mentioned above to help you through this process:


Advance Care Planning: Healthcare Directives. (n.d). Retrieved from

Benefits of Advance Directives. (n.d.). Retrieved from

California Advance Directive. (n.d.). Retrieved from

DNR and POLST Forms. (n.d.). Retrieved from