Notes from the Parish Nurse: Honoring Choices

Honoring Choices Minnesota is an initiative that encourages individuals to plan for their advance care. “The process of advance care planning (ACP) involves conversations throughout life about your values, beliefs, and goals for future health care. ACP conversations focus on your health care goals and what is important to you.” This process makes sure that your wishes will be known at a time when you may not be able to make your own medical decisions or cannot communicate your health care choices, such as after an accident, worsening of an illness, or sudden illness. It is best to make these decisions when you are able to make your own choices and thus give yourself peace of mind. Regularly revisit your decisions and plans because as one gets older, health status and goals, values, and priorities might change.

“Documenting your wishes in a Health Care Directive is important. The document outlines your values and priorities for future medical treatment and can identify your health care agent. A Health Care Directive limits confusion and helps everyone prepare for the unexpected.” Choosing a health care agent is a vital step in advance care planning. Your health care agent will be the person who speaks for you and makes decisions for you if you are unable to do so yourself. Important considerations in choosing this person include: 

• Do you trust this person to make tough decisions? 

• Will the person honor your wishes even though he/she doesn’t agree with them? 

• Can this person make important decisions in stressful situations? 

• Can this person stand firm on your wishes even though family members disagree? 

To complete a Health Care Directive, it is important to identify spiritual and personal beliefs that might influence your decisions on treatment. Then a written plan can be made that outlines your future medical treatment. Topics covered are often related to decisions about cardiopulmonary resuscitation, help with breathing, artificial hydration and nutrition, comfort care, dialysis, and hospice care. In Minnesota, you must have two adults or a notary public witness your signature on your directive. Keep your original Health Care Directive in a safe place in your home. Give copies to your health care agent, other family members, your primary care physician, and possibly to your local hospital. 

Many people have strong feelings about what they want or don’t want to happen if they become hospitalized or incapacitated. In order to have your “voice” heard, you need to communicate your feelings. This is a sensitive topic that is sometimes hard to bring up with physicians, friends, or family members. Fortunately local physicians, care center employees, registered nurses, social workers, parish nurses, and advance care planning facilitators are available in Northfield to help you start the conversation.