Advance Care Planning : Five Promises of Advance Planning : Plans are clear

This promise means more than ensuring that the legalities in completing an advance directive have been met. But it involves insuring that the plan truly reflects the individuals' values and preferences. It includes paving the way for honest communication and a commitment to involving the designated surrogate decision maker, appropriate family and loved ones and the health professionals in clarifying the patients' wishes and truly understanding them. It involves a re-assessment of the plan at regular intervals, when circumstances change or if the patient verbalizes different goals and preferences.

To evaluate whether an organization or community is meeting this promise, the following questions could be asked:

• What is the meaning of "clear?" Are advance directives reviewed for legal compliance? Are advance directives reviewed for clarity and understanding? Do advance directives reflect the individual's values and preferences?

• Are plans adequately communicated? Are plans reviewed by the patient's physician? Are plans understood by the physician? Are plans communicated to and understood by the chosen health care agent? Are plans comunicated to and understood by the patient's loved ones?

<<< Previous Next >>> [ Go Up ]