Practical guide
Choose the Person Who Could Speak for Your Health Care
Advance care planning starts with a conversation about your values, the person you trust, and the documents your care team can find.
Start before the decision is urgent
A name in an emergency contact field does not explain what care you would want if you could no longer make decisions. Advance care planning gives that conversation a place to happen before an illness or injury makes it urgent. It is relevant to adults who feel well, too. A health care proxy, or agent, is someone designated to make medical decisions when you cannot. A living will records treatment wishes. These documents serve related purposes, but choosing a person and explaining your preferences are separate tasks. Begin with both questions: who could speak for you, and what would you want that person to understand?
Ask about the responsibility
Choose someone you can speak with honestly and who is willing to support your wishes, even when those choices differ from their own. Availability matters. So does the ability to ask clinicians questions during a stressful situation. Consider a backup if your first choice cannot be reached. Have the conversation before putting a name on a form. Explain why you are asking, then give the person space to consider the responsibility. A useful discussion can include what matters in your daily life, what worries you about serious illness, and which beliefs should guide decisions. It need not settle every possible medical scenario in one sitting.
Connect the conversation to valid documents
Forms and legal requirements differ by state. Ask your health care team, state health department or a qualified legal adviser where to obtain the appropriate documents and what signing requirements apply. Naming a health care agent does not itself authorize someone to manage your finances. Ask a clinician to explain unfamiliar treatments before recording preferences about them. Medicare covers voluntary advance care planning in certain circumstances; costs depend on how the visit is provided. Check coverage and charges with the practice instead of assuming every planning appointment is free.
Make the plan available and keep talking
Once documents are completed, share copies with your agent and health care team and keep them somewhere accessible. Tell the people involved where the current version is stored. A carefully completed form cannot guide a decision if nobody knows it exists. Return to the conversation when your health, relationships or wishes change. Tell your agent and clinicians about revisions and follow the appropriate process for updating documents. The aim is a person who understands your priorities, supported by information the care team can actually use.
Sources & references
- Medicare: Advance care planning
- MedlinePlus: Health care agents
- National Cancer Institute: Advance Directives
- MedlinePlus: Advance Directives
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