Have a Say in Your Care

Our goals are usually to stay healthy and feel good for as long as we can. There may be something that prevents this such as an accident or sudden illness. It is important to be ready for any life event.

The following information will help you decide what to include in a health care directive. We want you to make and plan your own decisions about your health.

A health care directive will let your care team, health care agent(s) and loved ones know what you want if you are not able talk to them. It clearly shares your values, beliefs, and hopes for your care.

Who will speak for you if you cannot speak for yourself?

A health care agent is a person you pick to make medical decisions for you if you cannot. Choose one or two backup agents in case your primary agent is not available.

Your health care agent(s) should be 18 years of age or older and willing to:

Take on this role for you.
Listen to you.
Understand your values, goals, and health care choices.
Follow your choices, even when they do not agree with them.
Make decisions for you during hard times.

Think about your current health, quality of life, and personal values. Some people want to live as long as possible, while others value comfort and quality of life over medical treatments.

Talk about your answers to these questions with your health care agent(s):

What activities bring joy and meaning to your life?
What are your most important goals if your health were to get worse?
What do you want people who care for you to know about your spiritual and cultural beliefs?
What gives you strength when you think about your future? Some examples may include prayer, people in your life, music or family traditions.
What are your hopes for your health?

A health care directive should be clear and direct. These statements below are examples of ones you may want to include in your health care directive. Use these as a starting point. You can change them to fit your own goals.

Think about how you want to be cared for if you were injured or sick. What might you want to include in your health care directive?

I value my quality of life over length of life. I want to receive medical treatments or procedures only if they give me a chance to return to activities that bring me joy.
I want to live as long as I can. I want to receive medical treatments or procedures that help me stay alive.
I do not want to receive care only to prolong my life.
I want to have extensive medical treatments (such as CPR, ventilator, feeding tube) if my care team believes I can recover. To me recovery means:
If I am diagnosed with a terminal illness, I want to focus on palliative care and hospice services to manage my comfort. This is important to me because:
My mental health is important to me. If I cannot talk to or recognize my loved ones, I do not want medical treatments or procedures to prolong my life.
Being independent is important to me. To me this means:
I do not want to be a burden to my loved ones. To me a burden means:

Cardiopulmonary Resuscitation (CPR)

CPR is an emergency procedure done when someone’s heart and breathing have stopped. CPR can include:

Pushing hard and fast on the chest to help blood circulate.
Giving medicine.
Using electrical shocks.
Providing breathing support with a tube and a machine.
Going to the hospital.

Important things to know about CPR:

CPR doesn’t always work.
Recovering from CPR can be painful.
CPR is not always best if you are very sick, have a long-term illness, or are older.

Talk about CPR with your care team if your health changes. They may talk about if:

You have an illness or injury that cannot be cured, and you are dying.
CPR could do more harm to you.
CPR would not help you live longer.

Think about these scenarios. If I need CPR:

I want CPR if my heart or breathing stops.
I want CPR unless my care team thinks I may not survive or recover.
I don’t want CPR. I want to allow natural death if my heart or breathing stops.
If you choose this, talk more with your care team about other medical orders to support this choice.

Breathing Support

In some cases, a person may need special equipment to help them breathe. This may include a:

Ventilator: A machine that helps a person breathe. This machine pushes air into their lungs through a tube in their throat. The tube goes through the nose or mouth.
BiPap: A machine that helps push air into a person’s lungs using a mask that covers their nose and mouth.
Nasal cannula: A tube with prongs that go into a person’s nose to give them extra oxygen.

Think about these scenarios. If I need breathing support:

Noninvasive methods:
- I want to try non-invasive methods to help me breathe. If this doesn’t work,
  - I want to try a breathing tube (ventilator).
  - OR
  - I do not want to use a breathing tube (ventilator). Instead, I want to focus on comfort care.
Temporary breathing tube (ventilator) use:

If my care team believes I may recover from my illness or injury, I want to use a breathing tube for a short time. Here are some examples: being able to go home, talk to my loved ones, or live on my own. To me getting better means:
If there is a chance I may start breathing on my own again, I want to use a breathing tube. My goal is to live as long as possible.
I want to use a breathing tube for a short time, so my loved ones have time to say goodbye.
I do not want to be kept alive by breathing support for a long time. If I am put on a breathing tube and my health gets worse, I want breathing support to stop even if I die.

Breathing tube (ventilator) for recovery

If there is a chance I will start breathing on my own again, I want to use a breathing tube even if I may not recover.

Pain Control

Think about these scenarios. If I need to control any pain I have:

I do not want to be in pain. I want treatments that give me the most comfort to lower my pain, even if that means I am less responsive.
I want to be awake and aware of my surroundings. I only want pain medicine when the pain I feel is too much for me.

Feeding and Fluid Support

Think about these scenarios. If I need feeding or fluid support:

If I am no longer able to eat food or drink fluids by mouth, I want to get nutrition and hydration through a feeding tube and IV fluids.
If my care team believes I may recover from my illness or injury, I want to have artificial nutrition through a feeding tube.
If I am no longer able to eat food or drink fluids by mouth, I do not want a feeding tube or intravenous (IV) liquids.
I do not want a feeding tube if it is only to prolong my life.

Religious or Spiritual Practices

Think about your religious or spiritual practices. What is important to you?

Prayer is important to me. I want my faith community to pray for me.
I want a chaplain or clergy to visit and pray with me.
I want to be on the public prayer list.
I want my community of faith to know about my illness.
I want my care team and loved ones to know about traditions that are important to me such as prayer, music, scents, or sacred readings. For me: __

Location of Care

Think about where you would want to be cared for if you were recovering, sick or dying. Where would you want to be?

I want to die at home with the right level of comfort care.
I want to have hospice services for support and comfort care.
I do not want to be a burden to my loved ones. If I cannot take care of myself, I would like to be cared for in a health care setting. To me being a burden means:
I want my care team and loved ones to know about my spiritual and cultural beliefs
I am not religious. These beliefs are important to me:
I want my care team and loved ones to know these things do not support my personal beliefs:
If possible, I want to have care where my pet can be with or visit me.

Health Care Agent

Think about your health care agent. Is there anything else you want them to know?

I want my health care agent(s) to know that I am grateful for them and trust them.
When decisions need to be made for me, I hope my loved ones support each other and do their best to follow my wishes.
I want my health care agent(s) to keep these important people informed about my condition:
Music is comforting to me. I would like music to be played for me.
I want my health care agent(s) to consider the cost of care and treatments when they make decisions for me.

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