Guest Blogger - Graceful Passage LLC
Barbara Marshall, End of Life Doula
I would like to provide a practical approach to Advance Care Planning. For starters, I know for
most when they hear phrases like, “Advance Care Planning” or “Advance Directives”, they either
roll their eyes or simply just ignore the conversation altogether. Adults of all ages should have at
least the bare minimum of advance care planning documents in place. We never know what
could happen. Want proof of that? Who would have ever thought the USA would be in the midst
of a massive pandemic, which has resulted in mandatory mask mandates, the shutdown of the
economy and schools for over a year, and over 500,000 deaths? The answer is, no one. It is not
a matter of if something will happen, but rather when.
Simply put, Advance Care Planning (ACP) documents are a person’s wishes put in writing so
that others can act on the individual’s behalf, should it become necessary. ACP documents are
not only a gift for self, it is a gift for those who would be caring for you when something does
happen. Think of the ACP documents as a roadmap - getting an individual and their loved ones
from point A to point B. The ACP documents are not just for those with a terminal diagnosis.
EVERY adult should have the basic documents in place. ACP documents provide peace of mind
for the individual as well as their loved ones. One does not have to go through an attorney to
have these documents completed. For Indiana residents, most of the basic documents can be
found at https://www.in.gov/isdh/25880.htm (Indiana Advance Directives Resource Center
website). That being said, it must be noted that some documents may need notarized or
witnessed.
I am not an attorney, nor do I profess to be one. However, I spent nearly 9 years in the hospice
industry and, time and time again, I witnessed the angst that occurs when one does not have
documents in place. I saw loved ones in despair when attempting to make gut wrenching
medical decisions when the patient has not made their wishes known. I have been involved with
cases where a patient is in desperate need of hospice services and unable to sign their own
admission documents. That patient goes without the additional care and services they deserve
at the end of their life. I have been involved with families who have argued over the bed of their
loved one in an attempt to decide what mom or dad wanted. Therefore, I am providing a real
world practical overview of the basic documents that one needs to have in place. The basic
ACP documents may include:
1) Healthcare Power of Attorney/Surrogate/Proxy/Representative;
2) Living Will;
3) POST/Physician Orders for Scope of Treatment; and
4) Durable Power of Attorney.
Let’s do a review of each of these basic ACP documents:
Healthcare Power of Attorney/Surrogate/Proxy/Rep: Naming someone to be an individual’s
voice when the individual can no longer speak for self when decisions need to be made
regarding the clinical, medical or health status of that individual. The healthcare proxy needs to
be someone who will follow the individual’s wishes, not the wishes of the proxy. The proxy
needs to be aware of the individual’s wishes and willing to accept responsibility therein. The
representative appointment needs to be witnessed. The POA must be notarized. The proxy