Advance Care Planning

“It’s never too early. Who will be your voice?”

On April 16, we will celebrate National Healthcare Decisions Day, which exists to inspire and educate the community and healthcare providers about the importance of advance care planning.

Advance care planning is the process of exploring your healthcare wishes, sharing preferences with family and designated healthcare agents, and completing legal documents to prepare for the end of life.

While we cannot predict the future, we can put plans in place to ensure that our healthcare wishes are articulated and shared with those who can make decisions that reflect our values. It is a bit like planning for retirement; although we can’t foresee the financial markets in 20 years, we know what we have now and what we want our lives to look like. We make informed decisions, knowing adjustments can be made at any time.

Are you unsure how to start your advance care planning? Check out this resource from our friends at the Vermont Ethics Network.

Dr. Kelley Elwell, DNP, APRN, FNP-BC, Central Vermont Home Health & Hospice’s Palliative Care Nurse Practitioner, believes that everyone 18 years and older should, at minimum, have a health care agent.

Dr. Elwell emphasizes that advance care planning is essential if you have been diagnosed with a life-limiting illness such as cancer, heart, lung, or kidney disease, or Alzheimer’s or dementia.

“It is important to explore your values so your wishes can be followed. Wishes can change over time as your overall health status changes, especially if you have a life-limiting or terminal illness. It is never too early. Who will be your voice?” 

For some, advance care planning is a gradual process that unfolds over time and in stages. CVHHH is here to help. Here are important considerations as you start the advance-care planning process.

Understand the care options available to you.

If you are living with a life-limiting illness, you have two options: palliative care and hospice care. “Chronic illness takes so much independence from patients and their families. Palliative and hospice programs are effective in providing education, pain and symptom management, and holistic support to meet patients’ and families’ needs, and they can give back some control over what a person would like the end of their life to look like.”

Dr. Elwell advises people to think about their preferences and what she calls the hard NOs.

What would you not be willing to endure, even if those things could potentially lengthen your life? Questions to ask include: What matters most to me in a healthcare context? Who do I trust to honor my healthcare wishes and speak on my behalf? Where do I prefer to die (in a hospital, at home, in a facility)?

Dr. Elwell spends significant time educating people on what certain interventions, such as CPR and intubation, look like in real life.

“It is not what we see in the movies. I advise people to understand how these things can impact their quality of life, even if it temporarily extends the length of their life. Do what you can to research and identify the interventions that are unacceptable to you and what means the most to you. As a healthcare community, we need to normalize ACP discussions in younger populations. No one is promised tomorrow, and by offering time and space to explore an individual’s wishes, we will create a culture of preparedness for the end of life.”

Dr. Elwell is available for consultations in-person at your home or by phone to discuss your condition and care goals and answer questions about how CVHHH can help you have the best possible quality of life and maintain your independence.

Call 802-223-1878 and ask to speak to Dr. Elwell.

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