The first step is thinking about what matters most to you and how that might influence future health care decisions.

Some questions you can consider during this reflection: 

• What gives your life joy, meaning and purpose?
• What does "quality of life" mean to you?
• What would you be willing to give up or tolerate to keep what matters most to you?
• Has anyone close to you died? Do you think their death was a "good" death or "bad" death? Why? What would you consider a "good" death?
• Do you have a medical condition that may get worse, and how will this affect your quality of life?
• Are you having medical treatments that affect your quality of life? What medical problems do you think you might have in the future?
• Who would you want to speak for you about health care decisions if you could not communicate for yourself?
• Are there circumstances when you would want CPR, mechanical ventilation, artificial nutrition, or artificial hydration? Are there any treatments you know you would want? Are there treatments you know you would not want?
• Where would you prefer to spend your last few months, weeks, or days? In your home? Nursing home? Hospital?

• With your healthcare team:
  • Having a conversation with your healthcare provider (s) is an important step in the advance care planning. Your provider(s) can give you information about your current health and what you might need in the future. They can also provide information about the types of decisions that may need to be made in an emergency including things like CPR, mechanical ventilation, and feeding tubes. Your healthcare provider(s) can share your potential outcomes with different treatments to consider in making decisions about your future care.
• With your loved ones:
  • Talk to your loved ones about your values, what matters most to you and your treatment preferences for future health care. These choices should be talked about with the people who would most likely be involved in making decisions on your behalf. It is important to remember this is probably something you will discuss more than once. The more you talk about your choices for care at the end of life, the more comfortable you and your family will become.

Choosing a medical spokesperson is one of the most important steps in planning for future care. This is the person who will speak and act on your behalf if you no longer can for yourself. Once you have chosen someone, it’s very important to communicate your choice to both your health care providers and loved ones so everyone is on the same page. 

If you do not legally appointment a healthcare representative, your decision maker will be determined based on the Indiana medical consent hierarchy law in the following order:  

1. A spouse.
2. An adult child.
3. A parent.
4. An adult sibling.
5. A grandparent.
6. An adult grandchild.
7. The nearest other adult relative in the next degree of kinship.
8. An adult friend who has maintained regular contact with the patient, and is familiar with the patient's activities, health, and religious or moral beliefs.
9. The patient's religious superior.

Now that you have thought about your wishes, talked to your medical team and family, and selected a decision-maker, it's time to document these wishes. By taking this step, you give your loved ones and your medical team the information they need to be able to honor your choices. 

Advance Care Planning documents are often referred to as Advance Directives. These are legal forms that provide instructions about your healthcare, in case you are unable to make healthcare decisions for yourself. This can include who will make decisions for you and what care you might want.  

Indiana Healthcare Representative Appointment 

• Legally appoint your chosen decision-maker
• Requires 2 witnesses, no notary
• Appropriate for everyone 18+ years old
• Indiana Advance Directive 2023 - Representative Appointment Only (indianapost.org) 

PREPARE Your Care

After you complete your Healthcare Representative Appointment and any other Advance Care Planning Documents/Advance Directives listed above, share this information with your Healthcare team.   

1. Bring a copy of your Healthcare Representative Appointment to be uploaded into your medical record
2. Share who you have chosen to be your decision-maker
3. Tell them your values and wishes you want added to your medical record

You should be sure that your family, health care power of attorney and health care providers know and understand your decisions. Some families can do this in one conversation, and others will need more. There is no right or wrong way to have these conversations. They also need to have access to your documents and be able to find them.

Review your Advance Directive documents any time your health condition changes and ideally once a year. A good guideline is to revisit your Advance Directive when there are major changes in your life (marriage, birth of a child, significant illness, divorce, death of a family member, etc.) or at least once a year. 

It is normal for your thoughts, perspectives, and viewpoints to change over time. Make sure your documents reflect your current preferences about end-of-life choices and who you want making decisions on your behalf. 

If your wishes have changed, return to step 2 of this Advance Care Planning Process.