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Planning ahead

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Know your choices, share your wishes

Whether you are healthy or have an ongoing or serious illness, it is important to think about what your health care choices would be if you become unable to speak for yourself. These decisions can be written down in a document called an advance directive or in your physician's notes.

Our video on advance care planning will help you understand the different levels of care you may receive in a medical crisis.

Advance care planning

Advance care planning means planning ahead as much as possible for the type of care you prefer if you become too ill to communicate your wishes. Because this type of planning for the future can be difficult to discuss with loved ones or your doctor, you may have to take the first step in bringing up the topic for discussion.

Depending on your specific condition, this could mean decisions about a number of things, including:

Advanced care planning includes deciding what being independent means to you and whether you would prefer to die at home or not. It also includes how much you want your care to involve family members or paid helpers. Spend some time thinking about your spiritual beliefs, your view of dying, and funeral preferences. Let your loved ones know your choices.

Take into account that even the closest relatives may not agree with your wishes. Select someone who truly can speak for you and be an effective advocate for the choices that you — and not anyone else — have made.

Remember that medical conditions, living situations, and preferences change over time. Review your documents from time to time to make any necessary changes or updates.

Advance directives

An advance directive is a legal document that helps ensure that your health care wishes will be respected if you are severely injured or develop a serious illness that prevents you from actively participating in decisions about your medical care.

Get advance directive forms for your state with step-by-step instructions on how to fill it out.

Your advance directive should be copied and shared with your doctor, attorney, caregiver, and family/friends. Keep your document in a location that is safe and easy to access.

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Do Not Resuscitate (DNR) Order

A Do Not Resuscitate (DNR) order tells health care providers not to perform cardiopulmonary resuscitation (CPR) or other life-support procedures if your heart stops or if you stop breathing. A DNR order is signed by a health care provider and put in your medical chart. Talk with your doctor if you want to have a DNR in your medical record.

Physician Orders for Life-Sustaining Treatment (POLST)

A document similar to the DNR is the Physician Orders for Life-Sustaining Treatment (POLST) form or Medical Orders for Scope of Treatment (MOST) form. Created specifically for patients with serious, advanced illness, this form provides medical orders concerning end-of-life care. Talk with your doctor if you want a POLST form for your medical record.

For more information

  • Some Kaiser Permanente facilities offer classes on advance directives and end-of-life decision making. View our health classes directory to find a class near you.
  • If you have questions about advanced care planning, email your doctor or talk to him or her at your next visit.

Reviewed by: Arthur Hayward, MD, April 2014
Additional Kaiser Permanente reviewers

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