PAID EDITORIAL

Supported Decision-Making and Advanced Planning: When Your Patients Need Support

Contributed by Roxanne Jenkins

Advanced planning could have made communication regarding treatment choices less arduous for many people who found themselves critically ill and isolated from their loved ones during the pandemic. The physician’s ethical code adheres to person-centered care, respecting an individual’s autonomy and commitment to their wishes for treatment.1 Health crises can occur at any time. When patients have outlined their wishes and have legal representatives in place, medical staff know the care they administer aligns with their patient’s choices. Without a health care directive and proxy when a patient becomes unable to communicate, doctors may administer treatment which does not align with patient wishes or may cause unintended health or financial outcomes. The Journal of American Medical Association reported in 2020 that only one-third of adults in the U.S. have an advanced care plan in place.2 And, a 2021 AARP survey revealed that only 1% of older adults surveyed said the pandemic motivated them to complete a health care directive.3 Number of adults in the U.S. with: • Health care directive/health care agent: 33%2 • Will or estate planning: 46%4 • Power of attorney: 50%5 Advanced planning is an important conversation to have with the people in your care. It will help protect their rights to treatment choices should they become incapacitated and will guide your treatment plan. An opportune time to ask if a patient has an advanced care plan is when discussing medical care options for major health events or end-of-life decisions. Medical professionals have an intimate, yet professional, relationship with their patients, putting medical staff doing direct care in a unique position to discuss advanced planning. Having a health care agent in place to make decisions can ensure patients’ decisions will guide their care team. Having a power of attorney can help ensure financial matters are handled in a timely manner. For end-of-life planning, naming a personal representative of the estate can assure patients their wishes will be handled according to their will. Lutheran Social Service of Minnesota’s Supported Decision-Making Services can be a resource for your patients, including Health Care Agent, Personal Representative of the Estate and Power of Attorney. LSS can act in capacity of health care proxy, personal representative and/or attorney-in-fact for individuals. LSS is the largest provider of both supported and substitute decision-making services in Minnesota, with a long-standing reputation for trustworthy, ethical, person-centered financial, personal and medical decision-making. We have a statewide presence able to meet your patients’ needs in their own communities. If your patients need advanced planning services, consider Lutheran Social Service of Minnesota’s Supported Decision-Making Services. LSS can be a great resource to ease the path to more patients having advanced care plans in place before they need them. Learn more at lssmn.org/careplanning.

Roxanne Jenkins, Associate Vice President of Services for Older Adults, oversees service development and delivery, including Supported Decision-Making—focusing on empowering persons to be active participants in the design of their support network.

References 1. American Medical Association. “AMA Principles of Medical

Ethics, I, IV. Code of Medical Ethics Opinion 5.2.” Accessed July 18, 2022. https://www.ama-assn.org/delivering-care/ethics/advance-directives. 2. Auriemma, Catherine L., MD; Halpern, Scott D., MD, PhD; Asch,

Jeremy M., BA. 2020. “Completion of Advanced Directives and

Documented Care Preferences During the Coronavirus Disease 2019 (COVID-19) Pandemic.” JAMA Network Open. https://doi. org/10.1001/jamanetworkopen.2020.15762. 3. Horovitz, Bruce. 2021. “Pandemic Isn’t Spurring Older Adults to Discuss, Record Advance Health Care Wishes.” AARP, April 6, 2021. https://www.aarp.org/caregiving/financial-legal/info-2021/ poll-many-have-no-advance-directives.html. 4. Jones, Jeffrey M. 2021. “How Many Americans Have a Will?”

Gallop, June 23, 2021. https://news.gallup.com/poll/351500/howmany-americans-have-will.aspx. 5. Walls, Barbranda Lumpkins. 2017. “Haven’t Done a Will yet?”

AARP, February 24, 2017. https://www.aarp.org/money/investing/ info-2017/half-of-adults-do-not-have-wills.html#:~:text=A%20 little%20over%20half%20of,with%2041%20percent%20of%20 millennials.