When it comes to estate planning, one of the best changes Medicare made in 2016 was adding coverage for end-of-life discussions with your healthcare provider.
Most people avoid these discussions at all costs. After all, few people enjoy thinking about death. Unfortunately, our mortality is something we all share. Having these discussions, though unpleasant, helps ensure your healthcare provider knows and honors your wishes. Even if you have an advance medical directive, you want to share your wishes with your doctor.
What is Advance Care Planning?
Discussions may include a specific illness and its progression, preferred treatment plans, your wishes regarding palliative care, and your preferences regarding life-saving measures such as resuscitation and feeding tubes.
Your healthcare provider will even help explain the realities of your illness to family and friends, and discuss questions and concerns you and loved ones have.
Please note that advance care planning is NOT an advance directive, such as a medical power of attorney (POA) or living will. These are legal, estate planning documents, though you may discuss them with your provider during your advance care planning.
The Importance of Advance Care Planning
When it comes to medical care, the unfortunate truth is that advance healthcare directives are often not enough. We live in a litigious society. Physicians, hospitals, and other healthcare professionals often choose courses of action that protect them from malpractice suits. Unfortunately, this may go against your written wishes, especially in an emergency situation in which you become incapacitated and therefore are unable to make your wishes known. However, the combination of advance directives (especially a medical power of attorney and living will) and advance care planning ensures your doctor and your agent both understand your wishes and will work together to honor them.
The two main goals of advance care planning are establishing your medical agent (via legal documents) and communicating your wishes to your medical provider AND your chosen agent.
When Should You Talk to Your Doctor?
You may do this at any time. You may choose your annual wellness visit for this discussion, or any other scheduled doctor appointment. If you recently created or updated a living will or medical POA, this may also be a good time to discuss your wishes with your healthcare provider.
Remember, this is likely not a one-time conversation. If your health changes, or your provider changes, you want to review these plans, preferably annually.
When you schedule the appointment, tell the appointment-setter that you want to include advance care planning, to ensure he or she allots enough time for your appointment. Bring any relevant documents with you, such as your medical POA and HIPAA release form. The latter is a legal document that allows your named agent to access your medical information.
Though these discussions are rarely pleasant, having them while you still enjoy good health ensures your doctor and loved ones respect and honor your wishes.