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Advance Care Planning

Advancing Excellence in America’s Nursing Homes is a national campaign to improve the quality of care and life for the country’s 1.5 million nursing home residents. Find out if your nursing home is part of the Advancing Excellence Campaign. To sign up or get more information, click here.

Nursing homes, their staff and consumers can join in this effort by working on the campaign goals designed to improve quality. This consumer fact sheet explains the importance of advance planning for care after a debilitating illness or at the end of life.

What is advance care planning?

Advance care planning gives you a voice if you can no longer speak for yourself and allows you to plan for and express your wishes about future care. Advance care planning can explain the care you want provided after a serious accident, an illness, or when you can no longer make decisions for yourself.

What can you do to prepare?

Discuss Your Wishes: Talk with family, friends and caregivers about personal concerns, values and spiritual beliefs regarding end-of-life or emergency care. While this can be hard to do, it is important to discuss things like:

  • What quality of life means to you;
  • What kind of medical procedures you want;
  • What kind of medicines, if any, you want for pain or other conditions you have; and
  • Whether you wish to use hospice care to keep you comfortable at the end of your life.

You might think family members and the doctor already know how you want to be treated at the end of life but a frank discussion allows you to be certain they know what your wishes are. Having a plan in place makes it easier for family members and doctors to carry out your decisions about the level and type of care you want.

Plan Ahead:

Make healthcare decisions ahead of time. This lets you choose the kind of healthcare you want or don’t want. No one has to guess what kind of care you’d prefer at the end of life or after a serious illness or when you are not able to communicate your desires.

Identify Your Advocate:

Pick a person to make healthcare decisions for you when you can’t make them yourself. This person is sometimes called a proxy. The person you choose needs to be able to make decisions based on your values and wishes about care. A good proxy is someone who knows you, will likely outlive you and someone you trust. This person only makes decisions for you when you are unable to make them yourself.

Review and Update:

Periodically look over your advance care plan and update it when your situation changes or if you change your mind. You should also check in with your designated advocate periodically to make sure they are still able and willing to carry out your plan.

Why is advance care planning important for residents?

Advance care planning allows you to express your choices, personal concerns, values and spiritual beliefs so that your wishes are known. It can be whatever you want it to be— from aggressive medical procedures to care that keeps you comfortable. Using an advance care plan can relieve family and caregivers of the stress of guessing what kind of care you want at the end of life.

Why is advance care planning important for nursing homes?

Having information about you and your wishes helps the nursing home respect your choices and provide you with the care you’ve decided on. Having shared your wishes by talking, choosing someone to speak on your behalf and by writing up a plan, your caregivers will know they are caring for you in the way that you would want.

What happens if I don’t express my wishes through an advance care plan?

The decision to express your wishes is up to you. If you do not have such a plan, family, caregivers and people you may not know will have to make their best guess about the care you would choose. Without a designated person to speak for you, caregivers may not agree about the course of action and may make decisions you wouldn’t like.

What if I don’t know what I want?

There are people to help and good information available about advance care planning. Your doctor, nurse, clergy, attorney, ombudsman or social worker can give you information and share sample documents with you. Your public library will also have information.

Advance Care Planning Resources

National Healthcare Decision Day, or any of the following organizations: