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An Advance Directive in Seven Steps

An Advance Directive in Seven Steps. Introduction.

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An Advance Directive in Seven Steps

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  1. An Advance Directive in Seven Steps

  2. Introduction The Gift Initiative is a community education collaborative in Tennessee led by Alive Hospice with partners from Vanderbilt University, Saint Thomas Health, PearlPoint Cancer Support and a growing list of individuals who recognize the critical need for education about advance planning for serious illness and end-of-life care. Alive Hospice is grateful for the generosity of HUMANA for their recognition of the serious need for better and earlier communication between patients, families, and health care providers.

  3. Why is it a “Gift” to discuss and plan for end-of-life care? • What is an Advance Directive and who should have one? • What forms are involved, where do I get them, and will I need a lawyer to complete them?

  4. Step 1:What Constitutes an Advance Directive? • The Advance Care Plan • The Appointment of Health Care Agent • Both forms can be found on The Gift Initiative Website or at www.Alivehospice.org

  5. Advance Care Plan

  6. Health Care Proxy

  7. Step 2:Personal Reflection Exercise

  8. Personal ReflectionExercise Three things I value most about my life are: I hope that between now and the time when I die, I will have a chance to: When I hear the phrase “good death”, I think of: When I hear the phrase “bad death”, I think of: The thing I worry about most when I imagine dying is: I hope that when I am near death, I will:

  9. Step 3:Appointment of Health Care Agent • Formerly “Durable Power of Attorney for Health Care” Changed in 2004. • A Health Care Agent (also known as a Health Care Proxy) is the person appointed by a competent adult to make health care decisions on their behalf in the event that one becomes unable to make and/or communicate decisions themselves.

  10. Choosing your Health Care Agent • Your Health Care Agent should be someone who will be able to clearly communicate your wishes. • Do not assume that because a person is your next of kin that they are necessarily best suited to serve as your agent. • Do not assume that because a person knows you well, and agrees to be your agent that they “know” exactly what you would want. • Completing the form is not enough, CONVERSATIONS ARE VITAL!

  11. Step 4:Discussion of Quality of Life

  12. Step 5:Discussion of Treatment Options

  13. Step 6:Completing The TN Advance Care Plan • Review and discuss the forms other instructions, such as burial arrangements, hospice care, etc. • Organ donation • Signatures: *Note: Your signature should either be witnessed by two competent adults or notarized. If witnessed, neither witness should be the person you appoint as your agent, and at least one of the witnesses should be someone who is not related to you or entitled to any part of your estate. • You do not need a lawyer

  14. Step 7:Communication, Distribution, Review and Revision of your Advance Care Plan • Conversations are key , families and those closes to you need to understand your choices. • Give a copy of the form to your Health Care Agent • Discuss your wishes with your physician • Keep a copy in your personal files • What about my safety deposit box? (NO!) • Take time to review your plan in the future, your wishes might change. You can change your plan at any time. Destroy outdated copies.

  15. Additional tools and resources

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