Have you or your senior loved one done an advance care plan?
You may have urged your senior loved one to execute legal documents that spell out their wishes at the end of life. You may have also completed documents such as a DNR (do not resuscitate) order to dictate how you wish to receive medical interventions. But has your senior (or you as a caregiver) set forth your personal desires for caring?
Making wishes known, not just about who gets the desk or car, but how you want to be cared for when you can no longer express your wishes is important for family caregivers and seniors to document no matter their age.
These decisions are very personal and should be guided by your values, preferences, and life beliefs.
Caring for older adults, as well as considering our own needs as caregivers, should involve creating plans for care.
Common Desires to Include in a Care Plan
One in four households currently includes at least one person who is serving as a caregiver.
As we all age, the prevalence of chronic disease increases, affecting our need for care.
About one-fourth of people with chronic conditions are limited in their capacity to live independently and to do everything for themselves that needs to be done, such as personal care, housekeeping, or medication management. We may need help accomplishing these daily activities.
We usually have a specific way we like things done, too. Those should be spelled out in your care plan.
Here are some of the most common desires we all have as we age that should be included in our care plan:
- Controlling our pain
- Honoring our wishes
- Be treated as a whole person
- Receiving care in a homelike location instead of a facility
- Being surrounded with people we love (or restrict those we don’t want to care for us)
- Having enough money to cover our costs without leaving family to pay the bills
- Living with dignity as we age up until death
- Communicating effectively between person, family and healthcare providers
There are other things we can include in our personal care plan such as:
- Arranging for your pet when you can no longer do it
- Stating your desire for fresh flowers in your room
- Wanting to keep certain family or friends involved or refusing them to be involved, depending on your relationship
- Specifying the type of music to play when you are confined to your bed
- Listing any other type of special consideration that is important to you or your senior loved one and could be easily overlooked when you can’t tell them what you like
Keeping Your Care Plan Updated
Your wishes expressed in your care plan can change as circumstances in your life change. They are not written in stone.
As a matter of fact, they should be reviewed regularly (at least annually) and updated as often as things or people change.
Perhaps the person you anticipate will give you care becomes incapacitated or moves to the other side of the country. You should change your wishes so that those needs be fulfilled by someone you designate.
Did you know that Medicare has a provision to pay your doctor or other healthcare provider to help your senior complete any advance care planning, either as part of their annual wellness visit or as a separate Part B service? It can be billed as many times as needed with no limits set on frequency by the Centers for Medicare Medicaid Services (CMS). Take advantage of this time to discuss future medical changes or potential long-term needs so that the care plan can reflect these issues.
Communicating the Plan to Everyone
Just as you would with legal documents for the end of life, once you and your senior loved one have created a personal advance care plan, it should be shared with significant family members, the established healthcare proxy, and the healthcare team.
As many as one third of us do not want to have CPR or other heroic measures but most of us do not share our wishes with our healthcare provider.
Older adults in the early stages of dementia are able to make decisions about future care on their own. However, the majority eventually will be unable to articulate their wishes for advance care planning and must rely on someone else to do so.
It is important to create an advanced care plan while cognition allows them to make decisions and make those decisions known. Once cognitive loss progresses, the ability to communicate decisions about their desired care will be lost.
Care Planning for Caregivers
Advance care planning is not just for those who are aging. An accident can happen to us at any age.
We should all have a plan, regardless of our age or health status. A life changing event can mean that we will be unable to express our own desires and need someone to speak for us using our personal care plan.
Important questions that should be addressed by family caregivers, but are often overlooked, include;
- Who will care for your senior loved one when you are unable to do so?
- Who will manage their care?
- Where will they live?
- Who will help pay the bills?
- Who will be their advocate?
Enlisting the aid of the entire family will be an important part of seeing that not only your senior’s care is defined, but also yours as a family caregiver.
You may feel that taking time from your daily duties to consider and create an advance care plan is selfish. In reality, other family members will be thankful that you were thoughtful enough to guide them in providing care when the time comes.
Decisions about care made in advance are easier to follow than trying to think of what you (or your senior) might want family members to do.
It actually relieves their burden.