When should you make an advance directive?

This document names a person to make decisions for you in case you are not able to do so yourself. It also gives instructions for care preferences at the end of life.

That’s not morbid. It’s simply good medical communication. Recall the heartbreaking cases of young people in tragic accidents who lacked advance directives (Karen Ann Quinlan, Nancy Cruzan, and Terri Schiavo, to name a few). They were unable to speak for themselves, so their care was determined through battles in court.

It’s never too early to have an advance directive. Nevertheless, many adults put off the task of creating one. April 16 is National Healthcare Decisions Day. It is a good time to prompt your loved one to complete this document. (And don’t forget to complete one for yourself, too!)

Patients often expect that the doctor will bring up the subject of an advance directive “when it’s likely to be needed.” Waiting until there is a turn for the worse, however, may be too late. The patient could go into a coma or be so advanced with dementia that they can’t communicate their preferences.

Although everyone needs an advance care directive, there are red flags that you need to get one in place right away:

  • A hospitalization
  • A scheduled surgery
  • Diagnosis of a life-threatening illness
  • Diagnosis of dementia

If it’s too awkward for you to start the discussion with your loved one, ask the doctor to do so while you are in the room. (Physicians now have the ability to bill Medicare for a conversation about advance care planning.) You can then continue the conversation at home by downloading the form for your state and getting your relative’s wishes on paper. While you are at it, make one for yourself! Happy Healthcare Decisions Day.