Proactive Health Care Plans Help You and Your Loved Ones

AMES, Iowa – While no one can know for certain if they will get COVID-19 or how sick they may become, there is a way to limit some uncertainty, says Jeongeun Lee, an Iowa State University assistant professor and extension specialist in human development and family studies.
 
As Iowa and the nation face the continuing impacts of the pandemic, advance health care planning is increasingly vital, Lee said. Developing a proactive health care and emergency plan is particularly important for older adults and those with underlying health conditions, who are at high risk of becoming seriously ill and/or dying from COVID-19.
 
“You can take control of your situation by proactively weighing your options and having important conversations about your wishes, should a medical crisis occur,” Lee said. “By giving direction ahead of time, your loved ones, health care agent and doctors will know what matters most to you: treatments that match your goals, values, and priorities, and where you might receive care.”
 
A health care plan is a form that summarizes a person’s health conditions and current and future treatment options. Many care plans include information about medications, health conditions, health care providers, caregivers, emergency contacts and end-of-life care options. Often, people do not complete their care options, and this may have negative impacts on their health care decisions in times of need.
 
“Engaging in advance care planning is important now more than ever because one thing you can control at this time is who you ask to speak for you if you cannot speak for yourself. Doing so before a medical crisis allows time for reflection about how a serious illness may impact your health and life in general,” Lee explained.
 
“Planning ahead can have benefits for both you and your family beyond the current pandemic. You can update your care plan every year or any time you have a change in your health or medications to keep the care active,” Lee added.
 
Studies have shown that proactive planning for health care can reduce emergency room visits and hospitalizations, reduce health care costs, improve quality of life, and increase the likelihood that care will be delivered in accordance with patients’ wishes.  
 
It is neither comfortable nor easy to have these crucial conversations with your loved ones, especially during these challenging times. However, letting your loved ones know your preferences and choices will provide better peace of mind and a sense of control, as well as alleviate stress and burden for everyone involved.
 
Lee suggests several steps Iowans can follow.
Explore your goals, values and preferences. Think about your choices and how you would like to be treated/cared for. Ask yourself questions, such as: What is most important to you to live well? If time was short, how would you want to spend it? What personal, cultural or spiritual beliefs do you have, if any, that would impact your care? What worries you most about the situation? What fears do you have? When would it be OK to transition from curative care to comfort care?
 
Choose a health care decision maker and have conversations with this person. This person should accept this role; talk with you about your goals, values, and preferences; follow your decisions (even if they do not agree with them); and make decisions in difficult moments (stressful times, differing opinions, crisis situations).
 
Complete your health care directives (advance care planning). Decisions may relate to CPR, ventilator use, artificial nutrition (tube feeding) and artificial hydration (IV or intravenous fluids), and comfort care. Documents may include a Health Care Proxy Form, an Advance Directive/Living Will Form and a MOLST/POLST Form.
 
Let your loved ones know your preferences/wishes and share related documents. Do not assume your loved ones know your preferences.
 
“Conversations about things we can’t control can help to give a sense of control,” Lee said.

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About the Authors: 

Jeongeun Lee

Human Development and Family Studies
515-294-1884
jel@iastate.edu
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