Make an appointment with your doctor to discuss your care wishes

Posted October 5, 2016

This story was written for our sponsor, Transitions LifeCare

Americans generally don't look forward to a doctor's appointment. But what if the appointment were specifically to talk about how you wish to be treated in the future -- especially if you were in a situation where you couldn't communicate those wishes yourself?

Your physician will likely welcome such an appointment. Doctors want to provide the best care for their patients, so they typically are interested in knowing what you consider to be "best" for your personal goals and preferences.

What's more, in January 2016, Medicare introduced a new policy to pay physicians for having such appointments with their patients. If you're covered by Medicare, you're already covered to have this type of discussion with your doctor.

"I recommend making an appointment exclusively to talk about advance care planning with your doctor," said Dr. Billy Dunlap, who has been caring for patients in the Raleigh area for more than 40 years. "It's too important of a discussion to add onto another type of an appointment, and there may not be enough time during a regular appointment."

Start by sharing your goals

Don't worry about the medical details regarding the kind of care you want. Your doctor can help you fill in the blanks. Instead, begin by telling your doctor your wishes, such as the type of activities you would hope to be able to continue even if seriously ill, the quality of life you seek to maintain and the level of pain management you prefer.

Next, talk about preferences, such as if you would want any medical process possible to keep living or you don't want to be hooked up to life support systems if that's the only thing keeping you alive.

You also can discuss details, such as whether you would want to be resuscitated if your heart or breathing stopped, other medical procedures you want to avoid and who the doctor should contact if you’re unable to express other wishes yourself.

"The full focus should be on talking about the patient's options and wishes for what they would want done medically and -- just as important -- what they don't want done," Dunlap said.

Put your advance care plan in writing

In addition to talking with your physician about your care wishes, it's important to put those wishes in writing.

Your doctor's office can steer you to legal forms, such as a Do Not Resuscitate order and Medical Power of Attorney (to designate who you want to make medical decisions for you if you’re unable). Or, you can use documents such as Five Wishes, which is recognized as a legal document in North Carolina.

"Resources, such as hospice organizations, also are available to provide services many of my patients have found valuable, including in-home medical care for life’s final months, expert pain management, emotional and spiritual support, and companionship," Dunlap said. "So if you want hospice care and prefer a particular hospice provider, put those wishes in writing, too."

A written advance care plan is not only very important for the patient, it's truly a gift to their family, according to Dunlap.

"When you have your care wishes written down, family members don't have to guess what you want or make painful decisions they're unsure about on your behalf," he said. "In addition to giving written directives to your doctor, make sure a family member or two know where you keep a copy."

This story was written for our sponsor, Transitions LifeCare


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