National Healthcare Decisions Day

National Healthcare Decisions Day (NHDD) is April 16. This is the thirteenth year the country has observed NHDD, but the pandemic has made it more relevant than ever.

Hospice Care Plus is honoring the day by offering free resources to help individuals make and document their healthcare decisions.

Lisa Knicely, the Director of Outreach Programs at Hospice Care Plus and the organization’s lead social worker, says NHDD reinforces the importance of advance care planning.

“In our work, we see the critical importance of advance care planning every day. When family and healthcare providers know your wishes and those wishes have been documented, you’re much more likely to get the care you want.”

Advance care planning is the process of thinking through the care you want—and do not want—if a medical crisis strikes and you are unable to communicate your wishes. Advance directives are the legally binding documents that formalize those wishes.

Many wrongfully assume that advance care planning is only for the very ill or terminally ill. But, the COVID-19 pandemic has made clear how important it is for everyone to explore the process.

“When COVID hit last year, a lot of parents had adult children away at college. Suddenly, they realized that, if their child were hospitalized and unconscious, they would not be able to access information about them or make decisions about their care,” says Lisa.

Ninety-seven percent of Americans want their wishes in writing, according to The Conversation Project, a free, online resource for advance care planning. Yet, only about three percent have actually done it.

“A lot of people are confused about what choices can be made in advance, what they mean, and which are right for them,” says Lisa. “That may be one reason so few have completed advance directives. Resources like the Five Wishes booklet and The Conversation Project have excellent tools to help move past those obstacles.”

When you feel prepared to put your wishes in writing, there are at least four documents recognized in Kentucky that can be completed at little or no cost. Lisa recommends the Kentucky Living Will Packet as a starting point.

The packet consists of two documents: the Living Will Directive and the Healthcare Surrogate Designation. The living will lets you express general wishes about medical treatment, and the surrogacy form lets you designate someone to make decisions if you are unable to. The surrogacy form is important for everyone to have, regardless of health status.

For those who want to express a wider range of wishes related to spirituality, burial versus cremation, and more specific medical care choices, Lisa recommends Five Wishes and MOST (Medical Orders for Scope of Treatment).

“Five Wishes is a booklet that lets you document a surrogate and general medical care wishes, similar to the Kentucky Living Will Packet. But, it goes beyond those basics to express other wishes that are important to you, even if they aren’t legally binding,” says Lisa. “It also guides you through how to talk with your family about your wishes.”

Five Wishes is available online for a small fee. But, during the months of April and May, Hospice Care Plus will mail the booklet free to anyone residing in our six-county service area (Estill, Jackson, Lee, Madison, Owsley, and Rockcastle counties in Kentucky). Contact Hospice at 859-986-1500 or hospice@hospicecp.org to request.

MOST is a recent addition to the advance care planning options in Kentucky. It allows you to make more detailed healthcare decisions and is completed with your physician. A sample form can be viewed online. Lisa recommends reviewing the form in advance of an appointment with your physician, then completing it together.

“Since it is a relatively new resource, it’s a good idea to call to make sure your physician has the form on hand prior to your appointment,” she says.

Regardless of which document you choose, Lisa says the process of clarifying your wishes and communicating them can save individuals and families heartache and regrets.

“In hospice and palliative care, we see how much conflict, confusion, and profound grief can result when wishes aren’t known. It’s hard to make these decisions in the middle of a crisis, especially when family members disagree about the right course of action. When everyone is on the same page and these decisions have been carefully thought about, discussed, and documented, the crisis is still hard, but it’s much less likely to harm relationships, violate a loved one’s wishes, cause suffering, and lead to painful what-ifs.”

To take advantage of the free Five Wishes booklet or to ask general questions about advance care planning, call 859-986-1500 during regular office hours or email hospice@hospicecp.org.