Palliative Care

Planning Your Care

To start planning your care, first identify what things are important to you in your life.

Try completing these sentences and answering these questions:

  • As I look back, the things that were most important or that meant a lot to me were: [List your responses.]

  • The things I hope I will be able to do in the next few years are: [List your responses.] 

  • The people who are important to me are: [List your responses.] 

  • How do I feel about spending time in the hospital?

  • How do I feel about having a surgery?

  • What do I think about machines or computers helping my body?

  • How important is it for me to be independent?

  • How do I feel about living if I need someone else to do all my personal care (like bathing or helping me go to the toilet) for me? 

The things you value are important to tell your doctor about. Make sure your family members know, too.

All adults should prepare for end-of-life care. This is similar to writing a will and includes: 

Durable power of attorney for health care. You should pick one or more individuals to make decisions for you if you are not able to make your own choices. The health care surrogate or “durable power of attorney for health care” should understand your basic values and know what conditions you want to avoid. Should we distinguish between POA for matters other than healthcare? 

Advance directive. An advance directive usually contains the name or names of the durable power of attorney or health care surrogate. It is a legal document that must be signed, and the signature witnessed. Advance directives also permit you to state the kind of care you want or do not want under possible conditions. All states have advance directives, which can be found online. You can also get them from your state government . Lawyers can also help people write advance directives.

Several tools help people think about this sort of planning:

Aging With Dignity, a non-profit group, created Five Wishes. Five Wishes walks people through the following issues:

1. The person I want to make care decisions for me when I can’t.
2. The kind of medical treatment I want or don’t want.
3. How comfortable I want to be.
4. How I want people to treat me.
5. What I want my loved ones to know.

The Five Wishes document is a legal advance directive in 42 states and the District of Columbia when signed and witnessed.

The Conversation Project offers a free online tool, and booklets that you can download and print to help people talk with family or others about their values and priorities and plan for care at the end of life.

Other situations to consider:

  • How will you receive care when you can’t take care of yourself? If you expect a family member to care for you, you need a safety plan in case that person is not able to care for you.
  • What will you do in an emergency? How will you manage urgent or severe problems ? You can choose to go to the emergency department or hospital, or you can work with your doctor so you and your family can manage care at home.
  • Plan for a time when you might choose home health care instead of going to a clinic, or when you might choose hospice care instead of going to the hospital.

Published: March 2018
Medical Contributors and Reviewers: Craig Alpert, MD, FACC; Stephanie Cooper MD, FACC; Caroline Lloyd Doherty, AGACNP, AACC; Sarah Goodlin, MD, FACC, FAAHPM; Haider Warraich, MD

Infographic: Shared Decision-Making

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