Advance Care Planning
Advance Care Planning refers to a process of mapping out the types of medical and non-medical care you would like to receive at some future point should a life-threatening or terminal disease make it impossible for you to express your wishes at that time. This type of planning is an ongoing process. It is a process of thoughtful discussion between you and your care providers, spouse, family, and significant others. While this conversation often results in a document (see Advance Directives below), it is more than just a piece of paper. It is an effort to better educate yourself about alternatives regarding the end of life and an opportunity to educate your physician, spouse, family, and others about your values, goals, and wishes related to end-of-life care.
This communication between you and your health care provider can be done at any time, preferably when you are younger and still healthy. Once completed, it should be revisited on a regular basis - every five years or after any potentially life-changing event, such as marriage, divorce, death of a spouse, or the onset of a life-threatening disease.
Advance care planning usually produces an Advance Directive, which is a written document that helps to summarize the plans you have made for future care. These documents take several forms, such as a Living Will and a Durable Power of Attorney for Health Care. While they can be completed without the involvement of your healthcare provider, it is much preferred to do this together. The future usefulness of these documents is better assured if your healthcare professional has been part of the planning process.
Please click here if you need instructions for filling out your Advance Care Planning Documents
A Living Will, referred to as a "Declaration" on Nevada's official state form, briefly states your wishes regarding treatment that "only prolongs the process of dying." A living will ONLY takes effect when you are declared "terminal" - that is when two physicians (your primary physician and one other), agree that you have an incurable, irreversible condition that will cause your death in a "relatively short time." One version of Nevada's form also allows you to name someone to speak on your behalf, again, this will ONLY take effect when you are declared terminal.
A Durable Power of Attorney for Health Care is a document in which you designate someone to officially represent your views. Unlike other power-of-attorney designations, this type ONLY comes into effect if you can no longer express your own wishes regarding health care. Importantly, durable powers of attorney for health care differ from living wills in that it is NOT necessary for you to be declared terminal for the person you appoint (your proxy) to speak on your behalf. This type of document also allows you to express your wishes about care at the end-of-life in greater detail than is possible in a living will. There is an official state form for this purpose; many other groups provide forms that can supplement the state form.
The Nevada Revised Statute 449.626(2) prioritizes the order of authority in the event a written directive does not exist as follows:
1. The spouse of the patient;
2. An adult child of the patient or, if there is more than one child, a majority of the adult children who are reasonably available for consultation;
3. The parents of the patient;
4. An adult sibling of the patient or, if there is more than one adult sibling, a majority of the adult siblings who are reasonably available for consultation; or
5. The nearest other adult relative of the patient by blood or adoption who is reasonably available for consultation.