Advance Care Planning
Advance care planning is a process to help any adult at any stage of health understand and share their goals and preferences regarding future medical care.
This will help your provider, family, and friends know what you want in case of a sudden medical crisis, accident, or if you become seriously ill.
A part of advance care planning may involve completing an advance directive.
Advance Directives FAQs
What is an advance directive?
An advance directive is a document or verbal statement in which an adult person (18 years or older) states choices for accepting or refusing medical treatment or names someone who should make treatment choices if the person is no longer able to make a decision for themselves.
What is the purpose of advance directives?
IU Health recognizes that all competent adults have the right to accept or refuse any medical treatment. Many people have strong feelings about the kind of medical care they would like to receive or refuse in certain circumstances. Advance directives allow us to state our feelings clearly so that our care preferences can be honored even if we cannot speak for ourselves.
Are advance directives required?
No person is required to have an advance directive in order to receive health care services at IU Health. No conditions are placed on care provided based on whether or not an advance directive has been done.
Why does IU Health ask patients about advance directives?
Protecting your right to express choice through advance directives upholds the IU Health value of honoring what matters most do you. IU Health “supports the rights of the patient to participate in all decisions that affect their health care”. Federal law (the Patient Self-Determination Act of 1990), the Center for Medicare and Medicaid Services, and Joint Commission standards require that every health care institution ask patients if they have an advance directive and provide advance directive information to patients who request it.
Why is an advance directive important to patient care?
In certain circumstances the advance directive guides care if you are unable to speak for yourself. The advance directive titled “Appointment of a Health Care Representative” also identifies the person you have chosen to serve as substitute decision maker if you cannot speak for yourself. If you have an advance directive, your doctors and care team need to know about it. You should provide a copy for your medical record.
Where can I seek more information about advance directives?
For additional information, see information provided by the Indiana State Department of Health.
At the patient’s request, the nurse will contact trained personnel who meet with the patient to provide additional information about advance directives and can assist in completing the advance directive forms if requested.
Should I bring a copy of my advance directive(s) to the hospital?
Yes. When you are admitted to the hospital, it is important for you (or your family) to provide the hospital with a copy of any completed forms.
These decisions are not easy to make. Discuss your choices with your doctors, family and friends. When you have completed one or more advance directive forms, give a copy to your doctor for placement in your medical record.
When should I review my advance directives?
You should review your advance directives if any of the following are true:
- You change your mind on what is on your current form
- You have a change in your medical condition
- You have a family situation change (get a divorce or married, someone dies, a child turns 18)
- You have not looked at them in 5 years
What if I change my mind on my advance directives?
An advance directive can be changed at any time. All that is needed is for you to complete a new advance directive. The one most recently signed in the legal one.
The information contained on this page is presented for your information only. Because these forms may have legal implications, the information should not be considered complete or used in place of a consultation with an attorney. An attorney is not required to complete an advance directive.
As of Jan. 1, 2023, Indiana law permits any form or documentation for an advance directive. To ensure they are legal, they need to be signed by the patient and witnessed by two people or one notary. The witnesses cannot be the named Health Care Representative and only one can be a relative.
Appointment of a Health Care Representative
This form allows you to appoint another adult to make decisions about your health care, if you become unable to make your own choices. That person is expected to act according to your values. It is important that you talk with your Health Care Representative so they understand what is important to you.
If you do not appoint a specific person to speak on your behalf, Indiana law sets an order for family or friends to be asked to speak for you. If the first person in the order is not available, then we go to the next person on the list. If there is more than one person in a group (adult children for example), then the majority will decide what to do for you. The order in Indiana is: Spouse, Adult Child, Parent, Adult Sibling, Grandparent, Adult Grandchild, Nearest adult relative, Adult friend.
(Note: someone with “power of attorney” does not have the authority to make health care decisions unless this is specifically written in the legal Power of Attorney document. Your emergency contact in your medical record is not automatically your Health Care Representative.)
How to Select a Health Care Representative
The person you select as a Health Care Representative must meet the following qualifications:
- Be over 18
- Be willing to take on the role
- Be willing to talk with you about your wishes
- Understand and will honor your wishes
- Will speak up for what you want
- Make decisions in your best interest
- Reachable by phone in case of emergencies
Having a conversation with your Health Care Representative
Once you pick a Heath Care Representative, it is very important that you have conversations with them about what you would want if you became seriously ill or were in an accident. These conversations can be difficult, and they are important to make sure your wishes are respected. This should not be a one time conversation, but a conversation that happens over time.
Consider the following questions:
- What does a good day look like for you?
- What activities do you want to make sure you can do if you can recover from an illness or injury?
- What kind of life would you consider to be unacceptable?
- What sort of spiritual or cultural beliefs or rituals are important to you?
- What treatment you would (or would not) want if you were not going to get better?
- What is more important to you – to live as long as possible or to live a full life?
- Would you accept long-term nursing home care?
- What previous health care experiences help you make these health care decisions?
Physician Scope of Treatment (POST) Form
This form is a set of actionable orders for end of life patients across care settings. For more information and to download a copy of this form, please see www.indianapost.org.
Psychiatric Advance Directive
This form allows you, in consultation with your psychiatrist, to express mental health treatment preferences. This form is available only through your psychiatrist or other mental health counselor.
Out of Hospital Do Not Resuscitate Declaration and Order
This form allows you to say that you refuse CPR if your heart or lungs stop working when you are not in the hospital. Discuss with your doctor if you do not want to be resuscitated outside the hospital. This form must be filled out and signed by a physician.
Forms
The information contained on this page is presented for your information only. Because these forms may have legal implications, the information should not be considered complete or used in place of a consultation with an attorney. An attorney is not required to complete an advance directive.
As of Jan. 1, 2023, Indiana law permits any form or documentation for an advance directive. To ensure they are legal, they need to be signed by the patient and witnessed by two people or one notary. The witnesses cannot be the named Health Care Representative and only one can be a relative.
Appointment of a Health Care Representative
This form allows you to appoint another adult to make decisions about your health care, if you become unable to make your own choices. That person is expected to act according to your values. It is important that you talk with your Health Care Representative so they understand what is important to you.
If you do not appoint a specific person to speak on your behalf, Indiana law sets an order for family or friends to be asked to speak for you. If the first person in the order is not available, then we go to the next person on the list. If there is more than one person in a group (adult children for example), then the majority will decide what to do for you. The order in Indiana is: Spouse, Adult Child, Parent, Adult Sibling, Grandparent, Adult Grandchild, Nearest adult relative, Adult friend.
(Note: someone with “power of attorney” does not have the authority to make health care decisions unless this is specifically written in the legal Power of Attorney document. Your emergency contact in your medical record is not automatically your Health Care Representative.)
How to Select a Health Care Representative
The person you select as a Health Care Representative must meet the following qualifications:
- Be over 18
- Be willing to take on the role
- Be willing to talk with you about your wishes
- Understand and will honor your wishes
- Will speak up for what you want
- Make decisions in your best interest
- Reachable by phone in case of emergencies
Having a conversation with your Health Care Representative
Once you pick a Heath Care Representative, it is very important that you have conversations with them about what you would want if you became seriously ill or were in an accident. These conversations can be difficult, and they are important to make sure your wishes are respected. This should not be a one time conversation, but a conversation that happens over time.
Consider the following questions:
- What does a good day look like for you?
- What activities do you want to make sure you can do if you can recover from an illness or injury?
- What kind of life would you consider to be unacceptable?
- What sort of spiritual or cultural beliefs or rituals are important to you?
- What treatment you would (or would not) want if you were not going to get better?
- What is more important to you – to live as long as possible or to live a full life?
- Would you accept long-term nursing home care?
- What previous health care experiences help you make these health care decisions?
Physician Scope of Treatment (POST) Form
This form is a set of actionable orders for end of life patients across care settings. For more information and to download a copy of this form, please see www.indianapost.org.
Psychiatric Advance Directive
This form allows you, in consultation with your psychiatrist, to express mental health treatment preferences. This form is available only through your psychiatrist or other mental health counselor.
Out of Hospital Do Not Resuscitate Declaration and Order
This form allows you to say that you refuse CPR if your heart or lungs stop working when you are not in the hospital. Discuss with your doctor if you do not want to be resuscitated outside the hospital. This form must be filled out and signed by a physician.
