No one likes to think about end-of-life care. It can be a difficult and emotional process, but it is very important to make your wishes and healthcare decisions known to your family, friends and physicians.

If you are like most people, you may not even know what things to consider. If so, we recommend starting by reading through our 10 Things to Think About for End-of-Life Care. It will help you begin thinking about what kind of care you would want if you were unable to communicate for yourself.

Once you have thought about your wishes for end-of-life care, we encourage you to share them with your doctor, family members and friends. You may also want to document your decisions with advance directives. An advance directive is a set of directions you give about the healthcare you want if you ever lose the ability to make decisions for yourself.

North Carolina has three ways for you to make a formal advance directive:

Living Will - A legal document that informs your physician of your wishes if you have an incurable or irreversible condition that will result in death in a relatively short period of time, are permanently unconscious, or suffering from advanced dementia or any other condition that results in substantial loss of cognitive ability and health care providers determine that it is not reversible.

Health Care Power of Attorney (HCPOA) - A legal document that appoints a decision-maker who can make healthcare decisions for you during times when you are unable to make such decisions for yourself. 

Advance Instruction for Mental Health Treatment - A legal document that tells doctors and healthcare providers what mental health treatments you would want, and what treatments you would not want, if you later become unable to decide yourself.

Another kind of advance directive is a document called Five Wishes. Like a living will and HCPOA, it helps you express how you would like to be treated if you are seriously ill and unable to speak for yourself, Five Wishes also takes into account all aspects of a person's well-being: medical, personal, emotional and spiritual. The Five Wishes document includes both a living will and an HCPOA, so if you choose to use Five Wishes as your advance directive, you will not need to complete these other documents.

As part of your advance care planning, you may also want to take into consideration whether you would like to be an organ, eye or tissue donor.  

Seriously ill adults under long-term or hospice care may also want to complete medical order called Medical Orders for Scope of Treatment (MOST).

If you choose to have one or more advance directives, it is best to complete these documents before you come to the hospital. Bring these documents with you when you check in.  We will place them on your chart so that your healthcare team will know the choices you have made.

If you arrive at the hospital and do not have an advance directive but would like to make your wishes known, speak to your nurse about obtaining a copy of the Five Wishes form. We encourage you to read it carefully and talk it over with your family and physician. The nurse can also ask one of the chaplains to help you review the document.

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