PALLIATIVE CARE PARTNERSHIP

OF THE ROANOKE VALLEY

Palliative care Partnership of the Roanoke Valley

Advance Care Planning

Advance care planning is making decisions about the care you would want to receive if you become unable to speak for yourself. These are your decisions to make, regardless of what you choose for your care, and the decisions are based on your personal values, preferences, and discussions with your loved ones.

If you are in an accident or have an illness that leaves you unable to talk about your wishes, who will speak for you? You can tell your family, friends and healthcare providers what your wishes and personal beliefs are about continuing or withdrawing medical treatments at the end of life.

Advance care planning includes:

 

  • Getting information on the types of life-sustaining treatments that are available.
  • Deciding what types of treatment you would or would not want should you be diagnosed with a life-limiting illness.
  • Sharing your personal values with your loved ones.
  • Completing advance directives to put into writing what types of treatment you would or would not want should you be unable to speak for yourself.

 

There are a number of advance directive forms to choose from in the state of Virginia.  Follow this link to the options available:

Go to: Virginia Advance Directives

Advance care planning may feel overwhelming at first. That is a normal response. There are documents that can help you think through your personal values and wishes. Over time, with  thought and planning, these concepts begin to form our advance care plan. Resources that can support you through that process may be found at:

Completing an advance directive accomplishes two important purposes:

 

  • Naming an individual(s) that you would wish to make decisions should you not be able to make them for yourself.
  • Defines your wishes as they relate to care you would or would not want. Why is naming a decision maker important?

 

Why is naming a healthcare decision-maker important?

As long as you remain mentally able you get to make your own healthcare decisions. But our global population is living longer, and this typically means that older members are more likely to have compromised abilities as they age – including compromised decision-making ability. Even younger members can have a brain injury or other condition that makes them unable to fully appreciate the risks and benefits of an action (or refusal to take an action), or other implications of their decisions. 

People who are mentally able NOW can take steps to name their future decision-maker in the event they lose such capacity, whether such loss of capacity is temporary or permanent. This is best done through a written ADVANCE MEDICAL DIRECTIVE. In Virginia, an Advance Medical Directive would typically include a section appointing an agent to act on your behalf (the surrogate decision-maker), and be your voice and advocate for health care decisions. Such a Directive usually also includes an “End of Life” statement, expressing wishes about the types of care to be provided or withheld in the event of certain illness or conditions.

For the person who does NOT sign a written Advance Medical Directive and designate a decisionmaker before losing mental or cognitive capacity, Virginia law decides who will be their voice – and that may NOT be who YOU would choose. If you have not named a decisionmaker, the following individuals (or groups of individuals), in order of hierarchy, would be legally authorized to make your healthcare decisions: 

 

  1. Court-appointed Guardian
  2. Spouse
  3. Adult children
  4. Parents
  5. Adult brothers and sisters
  6. Any other relative in descending order of blood relationship

 

Additional information on the State Code of Virginia can be located at:

Go to: § 54.1-2986 - Code of VA - Advance Directive

It’s important to note that a designation of agent (which is a type of Power of Attorney) for healthcare purposes is generally NOT the same as a Power of Attorney for business and financial matters. A BUSINESS AND FINANCIAL Power of Attorney appoints someone to assist with or control/manage your financial affairs, such as paying your medical bills and utilities, and/or managing your financial accounts and investments. Although many such documents are drafted to include cross-provisions, a business and financial Power of Attorney will not generally grant authority for health care decisionmaking and advocacy. The roles of an agent under a health care directive and those under a business and financial power of attorney are very different in terms of their legal duties and responsibilities.

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