Step 1: Explore
Advance Care Planning - What Does It Mean?
Advance care planning (ACP) is the process of helping you, as our patient, and your family understand, reflect, and communicate your goals and values. Cone Health is right here with you honoring and aligning your goals and values to medical preferences in the event of an accident, sudden illness, or chronic condition that prevents you from speaking for yourself. ACP does not require a formal document to be created but is the first step in thinking about what medical treatment you would want.
This can feel like a daunting task, and something that’s easy to put off. After all, it’s not comfortable or easy to think about a medical emergency or death. We believe this can also be a very empowering task. You can make these important and thoughtful decisions now and live with the assurance that your wishes will be carried out if in the future you’re in a situation where you’re not able to advocate for yourself. Plus, we will be by your side helping in any way you need us to as you make these important decisions.
What is an advance directive?
Simply put, an advance directive is a legal way for you to make your medical treatment preferences known – and to ensure they’re followed. They capture the type of medical care you want to receive, guiding your family, friends and health care providers as they confidently carry out your medical wishes even if you’re not able to communicate them at some point.
Here in North Carolina, you have six options when it comes to advance directives. We’re here to walk you through the process to make sure you have everything in place to share your medical preferences down the road.
Also known as a treatment directive, a living will explains whether or not you want certain types of life-prolonging medical treatments, such as breathing machines and tube feeding, if you experience at least one of the following:
- An incurable condition that will end your life within a short period of time
- Unconsciousness with the expectation that you won’t regain consciousness
- Advanced dementia or other substantial and irreversible loss of mental function
Health Care Power of Attorney
In a health care power of attorney document, you name someone to be your health care agent. That means they’re able make health care decisions for you when you can’t speak for yourself. You may choose any competent adult who’s not your paid health care provider.
Your health care agent can make decisions about your care such as:
- Choosing doctors and facilities
- Determining mental health treatment
- Reviewing and sharing your medical information
- Starting or stopping life-prolonging measures
Advance Instruction for Mental Health Treatment
An advance instruction for mental health treatment expresses your wishes for mental health care if you’re not able to communicate them. Mental health treatment includes:
- Admission and retention in a facility for the care or treatment of mental illness
- Electroconvulsive therapy (ECT or “shock therapy”)
- Psychoactive drugs (medications that affect your central nervous system)
Additional forms may be used to document your treatment preferences as part of the advance care planning discussions with your healthcare providers:
Medical Order for Scope of Treatment (MOST)
A MOST form is a doctor's order that helps you keep control over medical care at the end of life. The form (usually on bright pink paper) tells emergency medical personnel and other health care providers what medical treatment you would want if you could not speak for yourself. A MOST form is signed by:
- The patient or patient’s health care agent
Do No Resuscitate (DNR)
A DNR is a medical order written by a doctor. It instructs health care providers not to do cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating.
Goals of Care
Your provider or other healthcare staff might document your goals and values in a form called a Goals of Care. This form is not a legal or medical document but rather helps you and the healthcare staff review what is most important to you. A Goals of Care form includes the following questions:
- Tell us about your current understanding of your health or chronic illness.
- What are your short and long-term goals? Are there any future special events for milestones that are particularly important to you?
- If your health were to decline and you needed more aggressive care to prolong your life would you want things like cardiopulmonary resuscitation (CPR), mechanical ventilation or intensive care?
Go to Step 2: Discuss