Advance Care Planning Q&A

Dr. Karishma Patel is a primary care physician at Primary Care - Woburn

No one likes to talk about death. However, initiating that conversation with loved ones before sickness or injury strikes is absolutely vital in making sure your end-of-life wishes are known and respected when that time comes. We talked to Dr. Karishma Patel, one of our primary care physicians at Tufts Medical Center Primary Care — Woburn who specializes in geriatric care, on the importance of advance care planning and how you can start that conversation today.

Q: What is advance care planning (ACP) and why is it important?

A: Advance Care Planning (ACP) helps individuals make their own informed wishes regarding any future medical care in the event they are unable to do so — for example, if they develop dementia or get into a devastating car accident. These wishes can include preferences on the use of feeding tubes, ventilators, CPR and more. It is important that they share their decisions with loved ones and the person they appoint as their Health Care Agent, so they can all abide by their wishes. Having these conversations will greatly reduce the burden and strain in the time of emergency.

Q: When can an individual start the ACP process?

A: It is never too early to start the process — one’s wishes can be changed as often as they like. Anyone that is a competent adult, at least 18 years old can make a health care plan.

Q: What does ACP include?

A: ACP can include the following:

  • Health Care Proxy — allows you to appoint a person to be responsible for making any and all medical care decisions, including life-sustaining treatment decisions, on your behalf. You may also limit their power or only allow them to make certain health care decisions when you fill out your Health Care Proxy form. When choosing your Health Care Agent, it’s important to think about your own wishes, and not theirs. Once signed and witnessed by two adults, this form is legally binding.
  • Personal Directive (“Living Will”) — gives you and your Health Care Agent specific information and instructions about your preferred medical care that allows you to carry out your religious and cultural beliefs and values. This form is not legally binding but is essential to ACP.
  • Medical Orders for Life-Sustaining Treatment (MOLST) covers your preferences regarding CPR, mechanical intervention and other life-sustaining treatments. Once signed by a physician, this form becomes a medical order.

Q: What are some ways people can initiate conversations about end-of-life with their loved ones?

A: Initiating the conversation about end-of-life or what to do if you were seriously injured or terminally ill can be hard to think about, let alone talk about. The “what if “questions can be challenging, so it is important to take a step back before emergency strikes, while your mind is still sharp and clear of any active distress. Honoring Choices Massachusetts is a great resource to help initiate the conversation.