General Q&A About Advance Care Planning

What is advance care planning?

It involves:

  • Learning about available life sustaining treatment options
  • Thinking about your values
  • Talking about your decisions
  • Documenting your wishes
  • Designating a decision maker on your behalf if and when the need were to arise

Why is it important to plan ahead?

Having advance care plans in place can help both you and your loved ones in the following ways:

  • When you are unable to speak for yourself
  • When sudden illness or accidents happen
  • By leaving a guide for others to follow
  • By giving peace of mind to loved ones

You live in New Hampshire. Aren’t your spouse’s or your loved ones’ rights to make decisions for you already recognized?

  • New Hampshire’s new “Surrogate Decision-Maker Law” took effect on January 1, 2015. The new law created an amendment to the State’s Advance Directives statute by creating a list of family members and friends, in order of priority, who may make health care decisions in certain situations for patients who don’t have a written Advance Directive.
  • Under the amended law, if a physician or nurse practitioner determines a patient is temporarily or permanently incapacitated (unable to understand, reason about and make a choice regarding the risks and benefits of a healthcare decision) but the patient has not previously authorized a health care agent through an Advance Directive, an adult relative or friend may be identified to make health care decisions on the patient’s behalf (act as a surrogate) for up to 180 days, in the following order of priority:

    • The patient’s spouse, civil union partner, or common law spouse. (Unless there is a divorce proceeding, separation agreement, or restraining order limiting that person’s access to the patient)
    • Any adult son or daughter of the patient.
    • Either parent of the patient.
    • Any adult brother or sister of the patient.
    • Any adult grandchild of the patient.
    • Any grandparent of the patient.
    • Any adult aunt, uncle, niece, or nephew of the patient.
    • A close adult friend of the patient. (As defined by the law)
    • The agent with financial power of attorney or an appointed conservator.
    • The guardian of the patient’s estate.
  • The “Surrogate Decision-Maker Law” is not meant to replace a written Advance Directive. The surrogate’s authority is temporary, for up to 90 days. There are other limitations as well. More information is available at the New Hampshire Foundation for Healthy Communities 
  • Completing a written Advance Directive is still the best way to make sure your health care decisions will be honored if you cannot speak for yourself.

 How can you get started on advance care planning?

  • Learn about life-sustaining treatments.
  • Reflect upon your values.
  • Decide what you want and do not want.
  • Talk to others.

Why is talking about your advance care planning decisions important and who should initiate it?

  • Discussion is a valuable opportunity to reflect on what’s important with loved ones.
  • Discussion needs to happen before a crisis.
  • Discussion can provide comfort to your loved ones.
  • Discussion is up to YOU to initiate.

What kind of questions should you ask yourself to help start a discussion with your loved ones and care providers about advance care planning?

  • What do you want and not want at the end of life?
  • Who should speak for you?
  • What are your concerns?
  • What gives your life the most meaning?
  • What one thing do you want to be sure your doctors, family and friends know about your wishes?