Advance Care Planning: Protecting Your Healthcare Choices

Your healthcare wishes are our top priority. But you may face times when you can't tell us those wishes. An unexpected illness or injury may leave you without a way for us to know your healthcare wants. That's why it's important to plan ahead. Advance care planning helps us make sure you get the right level of care that meets your wishes when you can't tell us yourself.

What is Advance Care Planning?

Advance care planning helps us understand and follow your healthcare wishes. We want to avoid confusion about how best to care for you in your most urgent times of need. Advance care planning tells us the kinds and levels of care you want. That way, when the unexpected does happen, you get the right care that matches your healthcare wishes.

The main way to communicate your wishes to us is by using an advance directive.

What is an Advance Directive?

An advance directive is a form that tells your family, friends, and healthcare providers what level of medical care you want when you're too sick or injured to speak for yourself. Writing down your healthcare wishes protects you and helps your loved ones make the right decisions for you.

With an advance directive, you can:

  • Name a person to be your healthcare decision-maker
  • Give healthcare instructions

If you change your mind, you can change your advance directive or totally discard it at any time. Your healthcare decisions are always up to you.

If you're over 18, you have the legal right to create an advance directive.

What Do I Do With an Advance Directive?

It’s important to share the details of your advance directive with your family, friends, healthcare providers, and healthcare decision-makers. That way, we can all honor the decisions you’ve made about your care.

What is a Healthcare Decision-Maker?

Your healthcare decision-maker is someone who’ll make the same choices you would. It’s important to talk to them about what matters most to you. This way you still have control over your own healthcare decisions.

How Do I Choose a Healthcare Decision-Maker?

When choosing a healthcare decision-maker, pick someone close to you who:

  • Will speak up for you when you can’t
  • Is willing to discuss the decisions you’d want if you were seriously sick or hurt
  • Will respect your wishes and follow your choices
  • Can stay calm and communicate clearly in stressful times
  • Can make sure your loved ones and healthcare team understand your choices

What Should My Healthcare Decision-Maker Know?

When choosing a healthcare decision-maker, talk with them about your thoughts and choices. This can help you reach your own decisions about your care. You may want all possible medical treatments if they can help you recover well. But if recovery isn’t likely or treatment becomes too hard, you might want to focus on comfort and quality of life instead of suffering longer.

Questions that you and your decision-maker might talk about include:

  • If you become so ill that treatment isn't likely to bring you back to a good state, would you prefer more time or a better quality of life? If so, when and what would that look like?
  • What abilities are so important that you can't imagine living without them?
  • If you were very ill, what wouldn't you want to go through for the chance of more time?
  • What gives you strength when you think about your future?
  • What are your biggest fears and worries about your health?
  • What are your most important goals if your health gets worse?

Always make sure everyone understands exactly what your choices mean when thinking through or discussing specific healthcare situations.

Who Makes Decisions About My Care When I Can’t?

If you don’t choose a healthcare decision-maker and don't have a court-appointed guardian, Virginia law states the order for who’ll get to make decisions for you:

  1. Your spouse (even if you're separated, unless a divorce is filed with the court)
  2. Your adult children (all must agree)
  3. Your parents
  4. Your adult siblings (all must agree)
  5. Other blood relatives (like aunts, uncles, nieces, nephews, or cousins)

Naming a healthcare decision-maker on your advance directive helps us avoid confusion about what kind of care you want, how far we should go in providing that care, and who gets to decide what your care looks like.