Advance Care Planning

Since we never know what may happen on any given day and life can bring unexpected twists and turns, it can be difficult to know what decisions may need to be made. Medical issues sometimes arise that create confusion and uncertainty for patients, their families, and medical staff. Everyone wants to do the right thing – but in some cases, it’s not always clear. Conversations with your loved ones now will save those dearest to your heart unneeded stress later. Don’t wait until it’s too late.

Not sure where to start?  Take comfort, our Advance Care Planning staff is here to help you each step of the way.

What is Advance Care Planning?

Advance care planning is a process which involves learning about the types of medical decisions that might need to be made as one progresses through life. Because goals are likely to change over time, conversations should happen multiple times during a lifetime, as circumstances change. Advance care planning focuses on learning about the types of decisions you might need to make if a medical crisis occurs, and determining what your goals would be in such a situation. It helps others know what kind of care you want. Your loved ones and your health care team cannot honor your wishes if we don’t know what they are.

Advance care planning involves two components: 

1. Choosing a person who you trust most to speak for you if you ever become so sick that you cannot tell us what your wishes are. This person is called a patient advocate. This person ONLY speaks on your behalf if you lose the ability to do so for yourself.
2. Putting your wishes in writing by way of advance care planning documents. These documents are referred to as an advance directive, a medical durable power of attorney and/or out of hospital Do-Not-Resuscitate (DNR) order. 

Everyone over 18 is encouraged to start advance care planning. You can make changes to your document(s) at any time.

Choosing Your Patient Advocate(s)

It’s important to pick the right person to be your patient advocate. Oftentimes a family member is a good choice because they know you well and understand what is important to you. Your patient advocate should be someone strong enough to act on your wishes, separate from their own feelings, even if those wishes may result in allowing you to die. Emphasize to your patient advocate that these are your decisions, not theirs. Remember, your patient advocate only directs care when you cannot.

Your patient advocate holds a significant responsibility. These responsibilities may include, but are not limited to:

• Communicating with your health care team about what your answers to medical questions would be if you could give them. 
• Indicating the kind of care you would or would not want in certain situations.
• Consent to or refusing medical treatments for you (including life-sustaining treatment). 
• Authorizing your transfer to other facilities if needed (nursing home, another physician, another hospital).

Completing Your Advance Care Planning Documents

Advance Medical Directive or Medical Durable Power of Attorney

In order for these documents to be valid they must meet the three requirements from the state of Michigan.

1. It must have two witnesses to your signature and does not need to be notarized in Michigan.
2. Witnesses cannot be your patient advocate(s), your health care providers, your DPOA for finances, or any person related by blood or marriage.
3. Your patient advocate(s) must sign an acceptance page that indicates they understand their responsibilities and they are willing to honor your wishes if they are ever called upon to do so. 

Please note that general or financial DPOA does not grant health care decision-making authority and you will need a separate document to address health care decision making. Once all your signatures have been obtained make several copies. Give copies to:

• Your physician(s)
• The hospital to which you are most likely to be admitted
• Your patient advocate(s)

You can provide a copy to Munson Medical Center in three ways:

• Fax to the Health Information Department at 231-935-6615
• Mail a copy to Munson Medical Center, HIM Department, 1105 Sixth St., Traverse City, MI 49684
• Email it to MMC-HIM-AMD@mhc.net. The email must include your name, address, birth date, and telephone number.

Making Changes to Your Advance Care Planning Documents(s)

You may make changes to your documents at any time. On your original document, cross out the old information and write in the new information along with your initials and the date the change was made. Make new copies to have your records updated. 

If you no longer have your original and we have a copy on file, you may request a copy of your advance medical directive be sent to you through our Health Information Management Department at MMC-HIM-AMD@mhc.net. In the subject line of the email please type: AMD Patient REQUEST. The email must include your name, address, birth date, and telephone number. 

Because we take patient information and privacy very seriously, someone from the Health Information Management Department will call you back to verify the request and complete additional identification requirements before mailing a copy of the document. 

Stories

Chuck and Linda's Story

In this Your Health Matters from 7&4 News, Chuck and Linda share their story and the importance of not only completing the advance directive forms, but also discussing your wishes with your loved ones.

Jim's Story

In this MedWatch from 9&10 News, we discuss the importance of advance care planning so that your family will know your wishes in the event that you cannot communicate them due to an illness or injury.

Tom & Jennifer Brokaw's Story

A daughter to father heart-to-heart from TEDx Stanford.