Document Healthcare Preferences and Future Decisions

Start with the decisions you want understood

An advance healthcare directive is a way to put healthcare wishes into writing for future situations. Before discussing documents, consider what you would want others to know if you could not communicate. You do not need to settle every question in advance; identifying what matters to you can give the conversation a useful starting point.

Think about the values behind your preferences, as well as the kinds of care decisions you want to discuss. For example, you might want to raise questions about life-sustaining treatment, comfort and pain relief, or artificial nutrition and hydration. The choices and their application depend on your circumstances, so bring questions rather than assuming a general example answers them.

• Write down questions or preferences you want to discuss.
• Note any health or family changes that may affect your planning.
• Consider who you want involved or informed about your wishes.

Consider who may speak or act for you

You may want to discuss whether to name a health care agent and what that person should understand about your values. A power of attorney is authority for another person to act as an agent; the role and authority of a healthcare decision-maker depend on the document and circumstances. Ask how your instructions and any agent designation fit together rather than treating them as interchangeable.

Choose someone you trust to understand your preferences and consider whether that person is willing and able to take on the role. You can prepare by listing questions about how the person would learn of your wishes, who else should be kept informed, and how to address disagreements or uncertainty.

Review related documents together

Bring any existing advance directive, living will, healthcare power of attorney, or HIPAA authorization. Reviewing them together can help identify instructions that may need discussion, gaps you want to ask about, or documents that reflect earlier preferences. Do not assume that an older document should be kept, replaced, or changed without considering its terms and your current circumstances.

A living will may express wishes about certain medical care, while a healthcare power of attorney concerns authority for an agent to act. Ask the attorney how the documents relate in your situation and what each one is intended to address. If you have a POST form or other medical order prepared with a healthcare provider, ask both the attorney and provider how it relates to your planning documents.

Ask about signing, changes, and access

The Tennessee Department of Health’s advance directive includes space for an agent, an alternate, care preferences and other instructions. Its signing section offers witness and notary alternatives. Review the complete instructions with counsel before using a form, and ask how to change an existing directive without creating conflicting versions.

After documents are completed, think through who should receive copies and where they can be found. You might ask whether your designated agent, family members, physician, or another care provider should have a copy, and how to keep the documents accessible if your circumstances change.

Prepare for a focused planning conversation

Gather existing documents and make a short list of your priorities, questions, and the people you may want involved. If you are unsure how to describe a preference, explain the concern in your own words; the discussion can help clarify what you want documented and what needs follow-up with a healthcare provider.

A useful next step is to discuss how an advance healthcare directive, any agent designation, and related documents should work together for your circumstances. Ask what signing requirements apply, how to make a change correctly, and how to share the completed documents so the people who may need them can locate them.