When Should You Start Advance Care Planning? A Guide to Timelines and Importance

According to the National Institute on Aging, every adult over 18 should consider advance care planning. Understanding when should you start advance care planning? and what it involves is crucial for ensuring your future healthcare wishes are known and respected, giving you and your loved ones peace of mind.

Quick Summary

Advance care planning is for every adult 18 and older, not just older or sick individuals, and should be initiated when you are healthy and able. Planning ahead for medical emergencies or end-of-life situations removes the burden from family members.

Key Points

• Start Young: Begin planning at age 18 to prepare for unexpected medical emergencies and ensure your autonomy is respected.

• Ongoing Process: Treat advance care planning as an ongoing conversation, not a one-time event, and review your documents regularly.

• Designate a Proxy: The most critical step is appointing a trusted healthcare proxy who knows your values and can advocate for you if you cannot.

• Reduce Family Burden: Documenting your wishes prevents loved ones from having to guess your preferences during a crisis, reducing their stress and guilt.

• Focus on Values: The core of advance care planning is prioritizing your personal values and goals for your quality of life.

• Review After Life Events: Update your plan after major life changes, such as a new diagnosis, divorce, or the death of a designated proxy.

Why Starting Advance Care Planning Early is Crucial

Many people mistakenly believe that advance care planning is only for the elderly or those with a serious illness. However, medical crises and accidents can happen at any age, leaving families to make difficult, emotionally charged decisions without guidance. Starting this process early, ideally once you turn 18, offers numerous benefits for you and your loved ones.

Benefits of Early Planning

• Reduces Family Burden: Documenting your wishes prevents the stress and guilt your family might experience while making medical decisions on your behalf.
• Respects Your Autonomy: Planning in advance ensures that your personal values and goals for your life and health are the primary guide for your medical care.
• Avoids Legal Disputes: By clearly designating a healthcare proxy, you eliminate potential legal and family disagreements over who has the authority to make decisions for you.
• Establishes Peace of Mind: Knowing your future is planned for, and that a trusted person is prepared to advocate for you, can provide a great sense of security.

What Exactly is Advance Care Planning?

Advance care planning (ACP) is more than just filling out a form; it is a thoughtful process of preparing for communication and medical decision-making. It involves reflecting on your values, discussing your preferences with your loved ones and healthcare providers, and documenting your wishes in legal documents called advance directives.

The Process Involves:

1. Reflection: Considering what is most important to you, your goals for the future, and what you would and would not want in different health scenarios.
2. Conversation: Talking with your healthcare proxy, family members, and doctors about your values and wishes.
3. Documentation: Completing the necessary legal forms, which vary by state, to officially record your decisions.
4. Review: Periodically re-evaluating and updating your plan to reflect any changes in your health, relationships, or values.

Essential Legal Documents for Your Advance Care Plan

Two primary documents form the foundation of an advance directive: a Living Will and a Durable Power of Attorney for Health Care.

Living Will

A living will is a legal document that specifies the types of medical treatments you would or would not want to receive if you were unable to communicate, particularly for end-of-life care. It can include preferences for ventilators, artificial nutrition, hydration, and CPR.

Durable Power of Attorney for Health Care (Healthcare Proxy)

A durable power of attorney (POA) for health care names a trusted individual to make medical decisions on your behalf if you cannot. This person, your healthcare proxy, should understand your values and be willing to advocate for your wishes. A POA covers a wider range of medical situations than a living will.

How to Have the Advance Care Planning Conversation

Discussing future medical care is important to align care with your values. To start:

• Start Simple: Discuss what gives life meaning and your goals.
• Share Your Plan First: Caregivers can initiate by sharing their own plan.
• Utilize Resources: Websites like PREPARE for Your Care offer guidance.
• Be Patient: Conversations may take time; focus on clarity.

Comparing Advance Directives

Feature	Living Will	Durable Power of Attorney for Health Care
Function	States specific medical treatment preferences, especially for end-of-life care.	Appoints a specific person (proxy) to make medical decisions.
Activation	Becomes active when a person is diagnosed with a terminal condition and unable to communicate.	Becomes active when a person is unable to make or communicate decisions.
Decision Scope	Limited to the specific treatments outlined in the document.	Grants broader authority for all medical decisions not explicitly prohibited.
Flexibility	Less flexible; relies on pre-defined scenarios.	More flexible; the proxy can adapt to unexpected medical situations.

Reviewing and Updating Your Plan

Your advance care plan is not static and should be reviewed and updated periodically to reflect changes in your life, health, and values. Consider updates after events such as a new diagnosis, marriage, divorce, death of a loved one or proxy, or changes in personal values.

Taking the First Step

Deciding when should you start advance care planning? is personal, but starting early while healthy is recommended by healthcare professionals. This process protects your autonomy and reduces the burden on loved ones.

Reflecting on your values and initiating conversations are key first steps. Learn more about the importance of starting early at CaringInfo(https://www.caringinfo.org/blog/why-begin-advance-care-planning/). Taking these steps helps ensure your healthcare wishes are respected.

Frequently Asked Questions

When should you start advance care planning?

You should start advance care planning as soon as you turn 18. This ensures that your wishes are documented and a trusted person is designated to make decisions for you in an unexpected medical emergency.

What is the most important part of advance care planning?

The most important part is designating a healthcare proxy, also known as a healthcare agent or surrogate, who can make medical decisions on your behalf if you become unable to do so yourself.

Do I need a lawyer to do advance care planning?

No, you do not need an attorney to complete advance directives, though some people choose to include it in their broader estate planning. You can find free forms and guidance from various reputable organizations.

What is the difference between a living will and a durable power of attorney for healthcare?

A living will documents your specific wishes regarding medical treatments at the end of life, while a durable power of attorney appoints a person (your proxy) to make medical decisions for you when you cannot.

How often should I update my advance care plan?

Your advance care plan should be reviewed and updated regularly, especially after major life changes such as marriage, divorce, a significant health diagnosis, or the death of a designated loved one.

What happens if I don't have an advance directive?

Without an advance directive, state law determines who makes medical decisions for you. This is typically a spouse, parent, or child, and can lead to family disputes and uncertainty about your wishes.

How do I talk to my family about advance care planning?

Start by sharing your personal values and discussing your goals for life and health. You can share your own plans first to make the conversation easier and remind them that it reduces their burden.