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Initiative stresses importance of advance directives

Apr. 12, 2018, 9:30 AM


While many might prefer to not think about dying, healthcare professionals throughout the United States are encouraging patients and their families to do just that during a national awareness campaign April 16-22 that promotes the importance of completing an advance directive for healthcare.

National Healthcare Decision Day, celebrated nationally on April 16, is part of a full week of education and events dedicated to educating and helping Americans complete an advance directive for healthcare. This document informs family, caregivers and providers about patient preferences for care, should they ever be in a position where they cannot make decisions about their medical treatment for themselves.

Vanderbilt Law School student Jenae Ward, left, and Vanderbilt University School of Nursing student Breanna Baraff discuss advance directive materials with patient Leona Campbell. (photo by Susan Urmy)

“Developing an advance directive is all about personal choice, but it’s also about preparing loved ones so it is easier for them to make healthcare decisions when the patient is no longer able,” said James Powers, MD, professor of Medicine, who specializes in geriatrics at Vanderbilt Health. “It’s so important to discuss your wishes on care with your family members. By doing this and by documenting your wishes through an advance directive for healthcare, you can make informed decisions and receive medical care that is consistent with your personal values.”

On April 17, members of the Vanderbilt HealthPlus team and representatives from National Healthcare Decision Day will be on site at the Courtyard Café from 11 a.m. until 1 p.m. to provide information on advance directives for healthcare. They will also have forms that can be completed.

Beginning in 2017 in Tennessee, the advance directive for healthcare form combined the content of the “living will” or “advance care plan” and the “medical power of attorney” or “appointment of healthcare agent” into one simplified form. In addition to providing information related to healthcare decisions, the form allows the selection of a healthcare decision maker (known as an agent), a person who is designated to ensure that the healthcare decisions of the individual completing the form are honored.

Since the mid-1970s, a healthcare advance directive has been the primary legal tool to communicate healthcare wishes regarding end-of-life care. However, it is estimated that less than 30 percent of adults in the U.S. have completed advance directives.

Mohana Karlekar, MD, medical director of Palliative Care at Vanderbilt, said she and her staff routinely talk with patients and their families about advance directives and the importance of completing these forms. Palliative care focuses on symptom management and quality of life improvement for patients who are facing life-threatening illness.

“Americans are, in general, feeling more empowered now to talk about their wishes with their healthcare providers and families,” said Karlekar. “I think part of this has to do with some of the recent books published such as “When Breath Becomes Air” and “Being Mortal.” These books have engaged people who normally might not have considered thinking about these questions and normalized these conversations.

“The reality is that all of us one day are going to be facing death, whether we like it or not. It seems to me the best way to advocate for ourselves and ensure our families are not left stranded in making difficult healthcare decisions on behalf of another is to have these conversations.”

Once an advance directive has been completed and shared with medical providers, it becomes a part of the patient’s medical record so a patient’s wishes are available to all healthcare providers involved in their treatment. It is also important that the family members who are involved with a patient’s routine care and wellbeing are provided copies so they are fully aware of the decisions that have been made, Powers said.

To learn more about advance directives and to find advance directive forms for Tennessee, visit

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