Advance care planning is about doing what you can to ensure that the health care treatment you receive is consistent with your wishes. If you become seriously ill or are unable to speak for yourself, having a plan in place allows your preferences to be known and, more importantly, honored. Advance care planning can help alleviate unnecessary suffering, improve quality of life and ease the decision-making burden on your loved ones.

If you don’t already have one, develop an advance care plan now, then revise and update it as your health status and circumstances change.

Common considerations when developing an advance care plan

Health history:

Have open and honest conversations with your doctor about your current health concerns, lifestyle and family history. Work together to understand what future health decisions you may face and plan the kinds of care or treatment you may want.

End-of-life care:

End-of-life care conversations should be a key part of the planning process. You’ll want to define an individualized plan that aligns with your personal preferences and ethical and cultural beliefs.

Home or facility care:

When possible, do you prefer to receive care at home or in a skilled facility? Having a home caregiver provides one-on-one attention, and there is often no substitute for the comforts of home. Conversely, a nursing home allows for a higher level of specialized care and support 24 hours a day.

Cost:

The cost of care varies based on care setting, geographic location and level of care required. But for context, the median cost of home care services is $30 per hour, according to A Place for Mom: Cost of Long-Term Care and Senior Living 2023 report. At $30 per hour, a full-time, in-home caregiver would cost approximately $5,200 per month. The median monthly cost of a nursing home is $9,034, according to Genworth Cost of Care Survey (December 2023).

Document your advance care plan

Put your preferences in writing and enable your loved ones to carry out your wishes by executing the supporting legal documents, including a living will/health care directive, power of attorney for health care and a financial power of attorney.

Living will/health care directive:

While it goes by a variety of names, this is a legal document that allows you to express your wishes with respect to the administration of medical treatment and life-prolonging procedures when you cannot communicate them. Work closely with your health care provider and your estate-planning attorney if you have specific preferences or special considerations to include.  

Power of attorney for health care:

A health care power of attorney or health care proxy appoints a person to make decisions for you when you are unable to do so yourself. The person you choose should be someone you trust who is able and willing to act and familiar with your values.

Financial power of attorney:

If you’re experiencing a serious medical event or lose capacity, you may not be able to take care of your financial matters, including paying bills or applying for long-term care benefits. A financial power of attorney allows you to designate an individual to make financial decisions on your behalf with respect to individually owned assets.  

Life-support measures:

In addition, you can elect to have do-not-resuscitate (DNR) and do-not-intubate (DNI) orders. A DNR or DNI informs medical staff that you do not want CPR or other life-support measures to be attempted if your heartbeat and breathing stop. Your doctor can add them to your medical record.

Share your advance care plan with loved ones

When you’ve completed your documents, find a safe place to keep them and share copies with your agents under your powers of attorney. Next, talk to family members and other important people in your life who have not been a part of the process yet.

Let them know who you’ve chosen as your agents and where important documents are kept. Consider having a conversation in which you share your preferences and how you developed them. You’ll also want to make sure they know current medical information — health care provider, primary/specialty doctors, preferred pharmacy, and life and/or long-term-care insurance policies. Also, be sure to share if you’ve made funeral arrangements or made deposits on senior housing. And depending on who you’re meeting with, you could discuss finances and how you plan to fund your care.

By having these conversations now, you help ensure that everyone understands your wishes. You can address hurt feelings and avoid confusion that could occur during more stressful times.

Review your plan regularly

Consider reviewing and updating your advance care plan after big life events, such as a change in marital status, a significant medical diagnosis or relocation to a new state. At a minimum, review your plan every three to five years to make sure it still reflects your current values and wishes.

Bring it all together

Finally, work with your financial advisor to develop a financial plan to complement your advance care planning. You might discuss the benefits of a health savings account or earmarking investment funds for health care expenses, creating options to help prepare for whatever the future holds.