When patients and their family are coping with end of life, there are many needs to consider. An advanced directive can be helpful to family and caregivers. In addition to an advanced directive, support systems need to be in place to assist with the patient as well as with the family and caregivers. One of the support systems available is hospice care.

Advanced directives are formal documents allowing people to state their wishes concerning end of life before they are unable make their own healthcare decisions. Even a young healthy adult would benefit from having an advanced directive form completed.

The advanced directive forms have to be

• witnessed by two people, both of which have to be an adult

• one who cannot be named as an agent and would not inherit any property
• at least one witness cannot be related by blood, marriage or adoption
• or notarized (Notaries typically are available at banks or government offices.)

There are two forms available; either of which can be completed. One form is called “Appointment of Healthcare Agent.” This form allows the person to name an agent and

alternate agent to make healthcare decisions if he becomes unable to do so himself. It is recommended that you discuss or write a letter to the healthcare agent and alternate agent named so they know your wishes and desires.

The other form is called an “Advance Care Plan.” This form is more detailed, allowing the person to provide more information and control of decisions made on their behalf. The person is allowed to identify what quality of life is unacceptable and which treatments he would or would not want if in the unacceptable condition. An agent and alternate agent are named on this form. Other instructions can be included such as burial arrangements, hospice care and organ donation.

Once witnessed or notarized, copies of the forms should be provided to all physicians involved in his care. A copy should always be brought to a healthcare facility when the patient is seeking care. It also is a good idea to give copies to the named healthcare agents as well as place a copy in the car. The form should be in an easily accessible place in case of emergencies.

Once a person is nearing end of life, hospice is an invaluable resource not only for the patient, but to the family and/or caregivers. Hospice provides a team of healthcare professionals such as nurses, social workers, chaplains and volunteers to support the patient and family through the entire process whether at home or in a facility. Hospice can assist the patient and family with the complex physical and emotional needs related to end of life care. Bereavement care also is provided to families for 13 months through the hospice team.

If you have any questions about end of life, please feel free to contact your physician’s office and/or social worker.

For additional assistance, contact Pastoral Care or the Cancer Institute.

Click here to read about Advanced Directives.