It’s probably the last thing you want to talk about: Your wishes should an emergency arise. Any conversation involving serious illness or mortality is likely to be difficult.
But it’s a conversation that needs to occur, said Dr. J.B. Sobel, chief medical officer for Medicare at Cigna Healthcare.
“It’s best not to wait until someone is seriously ill to talk with doctors, family and caregivers about their wishes,” Dr. Sobel said. “We recommend families discuss these things openly when it can be done rationally without the pressure of an urgent situation.”
According to research, only around 37% of adults have completed any advance care planning, which outlines their treatment and quality-of-life preferences should a health crisis occur.
“These kinds of decisions are deeply personal,” Dr. Sobel said. “They incorporate your values, your beliefs, your spirituality, and even your thoughts about your legacy. Because these decisions are so enduring, it’s important to share them with others. If you don’t discuss and document your wishes, then they may not be followed.”
That’s why it’s so important to have “the talk” with health care providers, close friends, and family members before illness occurs. By doing so, you will ensure your wishes are carried out by the people you choose, reducing your loved ones’ stress during an already difficult time.
But how do you get started, and exactly what should you do?
Advance care planning generally focuses on creating two types of documents: a living will and a medical power of attorney.
A living will or advance directive highlights which medical treatments you would or wouldn’t want to receive if you were seriously ill and unable to make your own decisions. This includes your wishes about things such as cardiopulmonary resuscitation (CPR), life support (artificial breathing on a ventilator), and food and nutrition (including the use of feeding tubes).
A medical power of attorney identifies the person who would make treatment decisions for you if you were incapacitated and unable to speak for yourself. This should be someone who knows you well and is comfortable with making these difficult decisions. It is often a spouse or a family member, but it can be anyone of your choosing.
These documents apply only to health care decisions. They do not apply to financial or money matters. You can use an attorney to develop living will and medical power of attorney documents, but an attorney is not required. Be sure to check the laws for your state, either through the state legal aid office or state bar association, to make sure you understand all the requirements to produce legally valid documents.
A number of tools are available to help with advance care planning. Cigna Healthcare, for example, now offers customers in certain qualifying Medicare Advantage plans access to a digital tool developed by Koda Health to help them navigate these conversations and communicate their preferences by generating living will and medical power of attorney documents. The tool is secure and can be accessed at any time through the web at no extra cost. It also gives you the ability to share the document with your health care providers, family, and caregivers if you choose.
The tool leads participants through a number of questions about their quality of life and health care preferences. By answering these questions, your wishes are easily documented and notarized online.
“We're excited to support Cigna's Medicare Advantage population through our comprehensive and scalable digital offering," said Dr. Tatiana Fofanova, chief executive officer of Koda Health. "This collaboration with Cigna represents a significant step forward in making advance care planning available to more people. Our shared goal is to empower older adults to take charge of their health care journey.”
If you don’t have access to a digital tool, you can get help with advance care planning from other sources, such as your local Agency on Aging. Your family physician is also a good resource.
Once you prepare your advance care planning documents, you should make periodic changes as your health or family situation changes.
“By planning ahead, you ensure you get the medical care you want, while helping your loved ones to reduce their anxiety should these decisions on your health care need to occur,” Dr. Sobel said.
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