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Advance Care Planning

Creating an advance directive to communicate your wishes for care at the end of life

We may not like to think about it, but at any moment we could face a serious medical crisis. One that could leave us unable to communicate with our loved ones or health care providers. Yet many of us haven’t prepared for this possibility. We haven’t formally communicated to our loved ones or our doctors the kind of treatment we’d want if we were too ill to make those decisions for ourselves. That means others will have to make these decisions for us without knowing for sure what we really want.

This forces doctors to make health care decisions without the benefit of that guidance. And if your loved ones don’t know your wishes, they may have to make difficult decisions about your care. Formally communicating your wishes – known as advance care planning – takes care of those you love, as well as yourself. It involves setting up an advance directive – a legal document that describes your wishes for end-of-life care.

4 steps to advance care planning

Here are the four key steps for creating an advance directive:

  1. Think carefully about the type of care you’d like to receive near the end of life, and where you’d like to receive that care.
  2. Discuss your wishes with your loved ones and doctors.
  3. Choose someone to be your health care agent (sometimes referred to as a health care proxy). This should be someone you trust to make decisions about your care if you become unable to.
  4. Put all of this in writing to formally document your wishes, and share it with your loved ones, health care agent and doctors.

Get help with creating an advance directive

We encourage you to start taking steps now to communicate your wishes. To get started, we suggest you check out Caring Conversations: Making your healthcare wishes known, a publication created by the Center for Practical Bioethics. It guides you through the process of creating an advance directive so your loved ones and doctors are aware of your wishes for end-of-life care. The booklet includes:

While the kit includes forms, we suggest that you download state-specific versions of these forms to be sure they meet all of your state’s requirements. In Massachusetts, this form is called a health care proxy form. It lets you name someone to make decisions about your medical care if you can no longer speak for yourself.

Other resources on advance care planning


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