Advance Care Planning

You have the right to make choices about your medical care. This right continues even if you are unable to communicate due to illness or injury. An Advance Directive (a written document giving specific instructions about your health care) is required to protect this right. This document can be a Living Will, Health Care Surrogate, Durable Power of Attorney, Emergency Medical Services - Do Not Resuscitate (EMS-DNR), or any document with specific instructions. Hospice staff recognizes these may be difficult decisions for you and your family. Many patients have found it helpful to include clergy, family members and attorneys in discussions about advance care planning.

Who can make an Advance Directive?

Any person, age 18 or over, who is of sound mind, may make an Advance Directive.

When does an Advance Directive go into effect?

Your advance directive goes into effect when you can no longer make decisions, give "informed consent," or communicate your health care decisions to others. As long as you are able to give informed consent, your Advance Directive is not used.

Must I have an Advance Directive?

No. You are not required to have an Advance Directive in order to get medical treatment, health insurance or to be admitted to our Hospice program. If you do not have an Advance Directive and cannot speak for yourself, these people, in the following order, can make health decisions for you;

  • A court appointed guardian
  • Your spouse
  • Your adult child (if you have more than one child, a majority of those children who are available for consultation)
  • Your parents
  • Your nearest living relative (if there is more than one of the same relationship, a majority who are available for consultation)

If you have opinions or strong feelings about what treatments you would or would not want (for example, feeding tubes or respirators), be sure to discuss them with your family, friends and Hospice team. It is the policy of Hospice of the Bluegrass to respect a patient's advance directive.

What is a Living Will?

A Living Will is a document which tells your doctor, other health care providers, family and friends whether you want life-prolonging treatments or procedures if you are in a terminal condition or a permanently unconscious state. It is called a Living Will because it goes into effect while you are alive.

What is a Health Care Surrogate?

A surrogate is an adult person who is appointed by you to make medical decisions for you if you should become unable to make those decisions yourself. This person should be someone who is aware of your wishes, values, and religious beliefs, and in whom you have complete trust and confidence to speak for you about health care choices. You can select almost anyone to be your surrogate. The only people who cannot be appointed are employees, owners, directors or officers of a healthcare facility where you are a patient (or resident) unless that person is related to you or a member of your same religious order. A person designated as surrogate can resign by giving written notice.

What is a "terminal" condition?

A terminal condition is defined as an incurable or irreversible condition for which medical treatment will only prolong the dying process, and without these treatments or procedures, death will occur in a relatively short time.

Do dying patients with Advance Directives receive the same care as other patients?

Yes. Each patient is given the same quality of care whether or not an Advance Directive exists. All patients are kept as comfortable as possible during their final hours or days.

How can I find out more about Advance Directives?

Your Hospice team can explain advance care planning and help you complete a Living Will or EMS-DNR. Hospice also has a video and written materials on advance care planning, which you are welcome to view. Please contact your Hospice team for further assistance.