What is advanced care planning, and how can living wills, trusts, estate plans, and Five Wishes help families prepare for future healthcare decisions?
Advanced care planning gives individuals the opportunity to communicate their medical preferences, identify someone they trust to make healthcare decisions on their behalf, and prepare for situations when they may be unable to speak for themselves. Rather than waiting until a medical emergency occurs, families can begin these conversations while everyone has the time and ability to make informed decisions. Living wills and advance directives help document medical treatment preferences, while healthcare surrogates can speak on someone’s behalf when necessary. Trusts and estate plans serve different purposes, generally addressing financial responsibilities, property, and asset management rather than medical decisions.
Five Wishes offers a practical starting point by helping individuals consider who should make healthcare decisions, what medical treatments they prefer, how comfortable they want to be, how they wish to be treated, and what they want loved ones to know. At Gulfside Healthcare Services, families can access Five Wishes documents free of charge when needed and receive assistance beginning these important conversations. By discussing preferences early and reviewing plans as circumstances change, individuals can help loved ones make decisions with greater clarity and confidence.
Talking about the future is something most families do on a regular basis.
We discuss retirement, financial goals, vacations, and plans for the people we love. But when the conversation turns to future medical decisions or what should happen if we can no longer speak for ourselves, things tend to get uncomfortable.
It’s easy to say, “We’ll talk about that later.”
The problem is that later isn’t always guaranteed.
Working in healthcare services, I’ve seen how quickly someone’s health can change. An unexpected injury, serious illness, or change in memory can leave a person unable to communicate what they want. Suddenly, family members may find themselves making decisions they never expected to face.
That’s why I believe we need to talk more openly about advanced care planning.
One of my priorities throughout my career has been helping patients and families understand their options so they can make informed decisions about their care. I don’t believe those conversations should start after someone becomes seriously ill.
Planning ahead doesn’t mean you’re expecting something bad to happen. It means you’re taking the time to explain your wishes while you’re still able to.
Living wills, advance directives, healthcare decision-makers, trusts, and estate plans may all be part of that preparation. They serve different purposes, but understanding how they work can help families avoid unnecessary confusion.
What Does Advanced Care Planning Actually Include?
Advanced care planning involves thinking about, discussing, and documenting the medical care you would want if you were unable to make decisions yourself.
It sounds straightforward, but there are many questions people don’t always consider until they’re faced with them:
- Who would you trust to make medical decisions for you?
- Are there treatments you would or wouldn’t want?
- What does being comfortable mean to you?
- Would your family know what matters most to you if you became seriously ill?
These are personal questions, and the answers aren’t the same for everyone.
Some people have strong preferences about life-sustaining treatment. Others may be more concerned about remaining comfortable, being surrounded by family, or having certain personal or spiritual wishes respected.
“I also want people to understand that advanced care planning isn’t reserved for older adults. An unexpected accident or medical emergency can happen at any age. Having a plan can be helpful even if you’re currently healthy.”
And the decisions you make aren’t necessarily permanent. As your health, relationships, or personal priorities change, your plan may need to change, too.
What Is a Living Will, and Why Does It Matter?
A living will is a legal document that explains your preferences for certain medical treatments if you’re unable to communicate your wishes. Depending on state law and your circumstances, it may address life-sustaining treatments such as mechanical ventilation, resuscitation, or artificial nutrition and hydration.
These aren’t decisions most families want to think about.
But imagine being asked whether your parent or spouse would want a particular treatment, only to realize you’ve never discussed it.
You might know that person better than anyone else, but that doesn’t necessarily mean you know what they would want in every medical situation.
That’s where a living will can help, because it lets you put your preferences in writing before someone else has to make those decisions.
A living will is also different from a traditional will as it concerns medical decisions while you’re alive. A last will and testament generally addresses what happens to your property and assets after death. Both may be important, but just keep in mind that they aren’t interchangeable.
Who Should Make Healthcare Decisions If You Can’t Speak for Yourself?
One of the most important decisions you’ll make is choosing someone you trust to speak on your behalf.
Depending on your state’s laws, this person may be called a healthcare surrogate, healthcare proxy, or healthcare agent. For example, in Florida, you can formally designate a healthcare surrogate to make healthcare decisions under the circumstances established by law.
This person doesn’t automatically have to be your spouse, oldest child, or closest relative, and I encourage people to think very carefully about who they choose.
Ask yourself a few questions:
- Does this person understand my values?
- Would they be comfortable speaking with physicians?
- Could they make difficult decisions under pressure?
- Would they respect my wishes even if they personally disagreed?
- Have I actually talked to them about what I want?
Naming someone is only part of advanced care planning. That person also needs to understand the responsibility they’re accepting.
What Is a Trust and Does It Cover Healthcare Decisions?
A trust is a legal arrangement used to hold and manage assets according to established instructions.
Depending on its structure, it may help someone manage property, provide for family members, determine how assets are distributed, or prepare for a time when they can no longer manage certain financial responsibilities.
If you have a trust, it doesn’t automatically mean your medical wishes have been addressed.
You may have a detailed plan for your finances and still have no document identifying who should make healthcare decisions if you’re unable to speak.
I recommend speaking with a qualified estate-planning attorney or financial professional to understand whether a trust is appropriate for your specific circumstances.
How Is Estate Planning Different From Advanced Care Planning?
Estate planning generally concerns your property, assets, finances, and how those matters should be handled during incapacity or after death. It may involve a will, trust, financial power of attorney, or other legal documents.
Advanced care planning focuses on the medical decisions that may need to be made while you’re alive.
Here’s how I encourage families to think about the difference:
- Who will manage my financial affairs if I can’t?
- Who will make decisions about my medical care if I can’t?
And those very well may be two different people.
Someone you’ve authorized to handle financial matters doesn’t necessarily have authority to make healthcare decisions. And your healthcare decision-maker may not have authority over your financial accounts.
I know legal terminology can be confusing, especially when families are trying to understand several documents at once, but you don’t have to figure everything out by yourself.
Healthcare professionals can help explain medical treatment options and care preferences. Qualified attorneys and financial professionals can help you understand estate-related decisions.
The important thing is to ensure both areas are considered, rather than assuming one document covers everything.
What Is Five Wishes, and How Can It Help Families Plan?
One resource I frequently recommend is Five Wishes.
Five Wishes is an advance directive and living will designed to help people explain their healthcare preferences using straightforward language.
What I appreciate about this document is that it encourages conversations that go beyond medical procedures. It also asks people to consider comfort, personal relationships, and how they want to be treated if they become seriously ill.
The document covers five areas:
Wish 1: The person I want to make care decisions for me when I can’t.
This helps you identify someone you trust to represent your wishes.
Wish 2: The kind of medical treatment I want or don’t want.
This addresses your preferences for medical care if you’re unable to make those decisions yourself.
Wish 3: How comfortable I want to be.
This allows you to explain what comfort means to you and what support you may want.
Wish 4: How I want people to treat me.
This takes into account your personal needs, dignity, and preferences regarding how others care for you.
Wish 5: What I want my loved ones to know.
This gives you an opportunity to share personal messages and wishes with the people closest to you.
“At Gulfside, we believe care should reflect the needs and wishes of each individual. Our approach includes medical care, pain management, psychosocial support, and spiritual support. I appreciate that Five Wishes encourages people to consider their personal needs alongside their medical preferences.
I believe Five Wishes can make advanced care planning feel less overwhelming because it gives families a place to begin.
Why Should You Complete Five Wishes With Someone You Love?
Don’t feel as though you have to complete Five Wishes alone. Sit down with someone you trust and work through the questions together: your spouse, an adult child, a parent, or the person you’ve chosen to make healthcare decisions for you.
You might discover that you’ve made assumptions about what the other person wants.
For example, you may know your parent wants to remain as independent as possible, but have you asked what that would mean if their health changed significantly?
You may know your spouse’s general opinions about medical treatment, but do you understand which personal concerns influence those opinions?
Some questions may be easy to answer. Others may require more thought or a discussion with your physician.
“It’s important to remember that completing the paperwork isn’t the only goal. The people who may eventually speak for you should understand your preferences. A document can record your wishes. A conversation helps the people you love understand them.”
How Can Gulfside Help Families Get Started?
I understand that some families want to plan ahead but aren’t sure what their first step should be.
They may have heard about living wills or advance directives, but never completed one. Others may feel uncomfortable bringing up the subject with a parent or spouse.
That’s one reason I believe resources like Five Wishes are so helpful.
Gulfside provides Five Wishes documents free to those in need, and we can assist families who want help starting those conversations. You don’t have to wait until someone is hospitalized or facing a serious diagnosis to ask about the document.
As a non-profit organization, serving people in need is an important part of our mission. Increasing community awareness and access has also been a priority throughout my career, and providing families with useful information and resources is part of that responsibility.
If you’re interested in learning more about Five Wishes, you can visit FiveWishes.org or contact Gulfside to ask about obtaining a document.
The goal isn’t to make decisions for you. It’s to help you begin thinking about your preferences and discussing them with the people who matter most.
When Should You Review or Update Your Plan?
One thing I encourage people to remember is that completing your documents doesn’t mean the planning process is finished.
Circumstances change. You may develop a new medical condition, be hospitalized, or begin thinking differently about certain treatments you once agreed to.
Your family circumstances may change, too. Maybe the person you originally selected as your healthcare decision-maker is no longer available or willing to serve in that role.
Those are all reasons to revisit your plan.
I recommend reviewing your documents periodically, and especially whenever a significant change occurs in your health, relationships, or personal preferences. If you make changes, make sure the appropriate people know.
Your healthcare decision-maker should understand your current wishes, and your physician or healthcare team should know where to find the relevant documents.
“An outdated document can create confusion if it no longer reflects what you want. That’s why advanced care planning should be treated as an ongoing conversation, not just a one-time thing.”
Taking the time to confirm that your wishes are still accurately represented can make a difference later.
How Can You Start the Conversation Today?
You don’t need to have every answer before you begin. Just start with a few questions, and if you’re not sure how to approach the subject, Five Wishes can help you work through it together.
I don’t believe advanced care planning can remove every difficult decision a family may face. Medical circumstances can change, and no document can anticipate every possible situation. But having a clearer understanding of someone’s wishes can absolutely help.
It also gives individuals an opportunity to participate in decisions about their future care while they still can. And it gives family members something to rely on if they’re eventually asked to speak on that person’s behalf.
You don’t have to make every decision today, but you can start the conversation.
And that may be one of the most helpful things you do for yourself and the people you love.
Frequently Asked Questions (FAQs)
1. What happens if I don’t have an advance directive and become unable to make medical decisions?
If you become unable to make healthcare decisions without an advance directive, state law generally determines who may be authorized to make those decisions for you. That person may be a spouse, family member, or another legally authorized individual. The difficulty is that they may not know exactly what you would have wanted. That’s why I encourage families to discuss their preferences and put them in writing before an unexpected medical situation occurs.
2. Do I need advanced care planning if I’m young and healthy?
Absolutely. Advanced care planning isn’t something you should only consider when you’re older or facing a serious illness. An unexpected accident or medical emergency can happen at any age. Having your wishes documented and choosing someone you trust to speak for you can help your family understand what you would want if you couldn’t communicate those decisions yourself.
3. Can I change my living will or healthcare decision-maker after completing the documents?
Yes. Your healthcare preferences and personal circumstances may change over time, and your documents should reflect those changes. You may want to update your living will after a significant diagnosis, a change in your treatment preferences, or a major family event. You can also change your designated healthcare decision-maker by following the applicable legal requirements. I encourage people to review their documents regularly and make sure their loved ones and healthcare providers have access to the most current versions.
4. Is Five Wishes a legally recognized advance directive?
Five Wishes is designed to serve as a legally recognized advance directive when it is completed according to the requirements of the applicable state. Those requirements can differ, particularly regarding signatures and witnesses. I recommend reviewing your state’s instructions before completing the document. Five Wishes can also be a helpful tool for conversation because it addresses medical preferences, comfort, personal wishes, and what you want your loved ones to know.
5. How can I get a Five Wishes document through Gulfside Healthcare Services?
At Gulfside, we provide Five Wishes documents free to those in need because we believe families should have access to resources that help them make informed decisions about their care. You can contact our team to ask about obtaining a document and getting help starting these conversations with your loved ones. You can also learn more about the resource at FiveWishes.org. You don’t need to wait until someone is seriously ill to begin planning.
