The Importance of Advance Care Planning
Most people say they want to be in control of their own medical care, but a staggering number of people have no plan in place should they become too sick or injured to make decisions for themselves.
Advance directives -- legal documents that outline how an individual would want their care administered -- exist to ensure a patient’s wishes are carried out, but a large majority of people delay completing them until late in life or never do, leaving potential decisions to be made on the fly by loved ones.
“When people haven’t stated what kind of care they want, it can cause trouble,” says Mia Morrisette, the Advance Care Planning Coordinator for UW Health. “Emotions in crisis can cause a lot of conflict.”
That’s why Morrisette is leading an effort to chip away at the number of UW Health patients who have no advance directive. Morrisette oversees a UW Health program that aims to more closely involve clinicians in advance care planning conversations with patients, and she coordinates classes that guide patients through the process of creating an advance directive.
“What we’ve learned is that people can be motivated to do this because they want to make health care decisions easier for their loved ones,” she says.
Lack of Planning Widespread
While advance directives are meant to lessen the burden of medical decisions on loved ones, statistics say they’re often an oversight.
Across the country, the lack of planning is widespread. A 2017 University of Pennsylvania study found that nearly two-thirds of American adults had not completed an advance directive.
Local statistics are similar. Among more than 41,000 UW Health patients 65 and older, only 40 percent have an advance directive in place and only 63 percent of patients 85-plus have one.
Common reasons for not having an advance directive range from lacking awareness about advance care planning to fearing conversations about difficult health situations with loved ones.
“There are some very challenging conversations but patients and their families find themselves in trouble when there’s a sudden decline in health and they haven’t laid out their wishes,” says Dr. Jeff Huebner, a family medicine physician at the Odana Atrium Clinic and Medical Director for Population Health Management.
Through a pilot program, Huebner’s clinic has engaged patients in discussions about advance care planning and referred them to Morrisette for Advance Care Planning Classes and individual appointments.
The feedback has been positive: Huebner says numerous patients have told him they wish they laid out an advance care plan sooner and that having support from UW Health was helpful.
“The whole goal of advance care planning is to help people be proactive in their health care,” he says. “This is some of the most fulfilling work for clinicians because it’s really helping build a relationship with the patient and helping them control their own care so it’s consistent with their wishes.”
As a next step, Morrisette and Huebner are working with clinical and population health leaders to facilitate a plan to deploy advance care planning referrals as a routine part of the care offered to patients that are enrolled in population health programs such as RN Care Coordination.
How UW Health Can Help With Advance Care Planning
There’s no such thing as too early to plan for future medical care, so UW Health offers free classes to help guide people through drafting an advance directive regardless of whether they’re a UW Health patient or not.
The 90-minute classes are intended to help people learn how to discuss their wishes with loved ones. They include an hour of information followed by 30 minutes for attendees to ask questions and get assistance completing their advance directive.
Once an advance directive is completed, Morrisette says it should occasionally be revisited according to the “Five D’s” of life events:
- Every decade
- After divorce if your spouse is named as your healthcare agent the document is invalidated
- A death (or dispute with your healthcare agent)
- After a new diagnosis
- After a decline in health
Updating advance directives under those circumstances ensures the correct person is named as your healthcare agent (the person who can make medical decisions for you) and that care plans more accurately reflect a patient’s values at their current stage in life.
Complete your advance directive with help from UW Health by signing up for a class today.
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Date Published: 10/17/2018