Take control – planning your health care

It’s always a good idea to plan for the unexpected. That’s why we carry umbrellas and have emergency flares in our cars. Planning ahead is an especially good idea when it comes to health care. “No problem,” you might say. “I have mine filled out and ready to go.”

That’s a great first step in making sure your family and your health care team know the type of care you would want if you had a health crisis and could no longer speak for yourself. But if you’re a Veteran with a serious or chronic illness, you might need to take your planning some distance further. And that means thinking seriously about what you want and then talking it over with your health care team.

When you’re facing serious illness, you already have a lot to deal with. But it’s worth it to take a moment and ask yourself two very basic questions:

• “What’s most important to me, now that I’ve got this illness?”
• “What do I want from my life and from my health care?”

Different people want different things. And what matters to you, personally, in your life should guide your medical care. The treatments and services that you get should be built around what’s important to you – your values – and what you want to get from your health care.

What you want from your health care

What would you like your health care to help you do?

• Ease your symptoms so you feel more comfortable?
• Stay independent?
• Cure an illness, or improve your quality of life when a cure is not possible?
• Live longer?
• Support your loved ones or caregivers?
• Something else?

Think about it carefully. Then set up a time to talk with your doctor or others on your health care team about what really matters to you as you look ahead. This can happen in person or over the telephone. Talk with them about your medical condition, what matters to you in your life and how your health care might help you achieve your goals.

Make sure you bring your health care surrogate to the meeting or invite them to join the call with your health care team. That’s the person who would tell your health care team what care you want – and don’t want – if you ever got too sick to speak for yourself.

If you’re seriously ill

If you become very seriously ill, there are treatments might or might not help you live longer, depending on your condition. All treatments have trade offs. It’s helpful to think through your options ahead of time so that you can make decisions that are right for you.

When you and your health care provider decide on a plan that will best support your goals, it will be written in your medical record. This plan can be updated at any time. If a crisis comes, your health care team will know what do, based on what you want.

For more information about setting health care goals and making decisions about treatments when facing serious illness, visit Health Care Ethics Resources for Veterans, Patients and Families or contact your VA health care team. They are here to help you.

Jill Lowery, PsyD., was an ethics policy consultant prior to being appointed as acting chief of ethics policy for VA’s National Center for Ethics in Health Care. Before joining the center, she served as clinical psychologist and integrated ethics program officer at the Durham VA Medical Center. Lowery holds a faculty appointment at Duke University Medical Center.