Advance Care Planning with Serious Illness
It is not always clear when a serious illness may occur or progress to a stage when further planning is needed. Sometimes an illness occurs suddenly and unexpectedly; other times an illness develops over a longer period of time. Some medical decisions are made over time and others are made in the moment, depending on how your illness presents itself. Regardless, your wishes need to be known.
More in-depth discussions may include considering:
- What is most important to you?
- What are your hopes and goals?
- How important is it to you to avoid pain and suffering even if it means you may not live as long?
- How important is it to you to be kept alive if you are permanently unconscious?
- What forms of life support would be acceptable to you and under what circumstances?
- In what situations would you prefer that medical care focus on comfort rather than cure?
- How important is it to you to be at home when you die?
Life support and life-sustaining measures refer to treatments and procedures to keep an individual alive. You can ask your medical provider to explain what each of the following would mean for you as it relates to your illness:
- Cardiopulmonary resuscitation (CPR)
- Artificial nutrition and hydration (IV’s and feeding tubes in the stomach or nose)
- Invasive artificial breathing machines (intubation, mechanical ventilation or tracheotomy)
- Major surgery
- Non-invasive artificial breathing machines (BiPAP/CPAP)
- Blood transfusions
Learn more about different life-sustaining treatments.
Your decisions need to be documented. Documentation can occur in different ways:
- Your medical provider can write down your verbal statements in your medical record and include specific details.
- In addition to your New York State Health Care Proxy you can consider completing a Combined Living Will and New York State Health Care Proxy.
- If appropriate, your medical provider can complete a Medical Order for Life Sustaining Treatment (MOLST). This form is not meant for everyone who is making end of life decisions.
A MOLST is appropriate for individuals who are living in a long-term care facility (nursing home or assisted living facility) or require long-term care services, and who may die within the next year and have specific wishes regarding life support.
Share all your Advance Directives with your physician, family, and health care agent.
As your disease progresses, your goals and choices for care and treatments may change. It is important to make clear to your family and health care agent any changes in your decisions.