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My Plan 1. If I have a life limiting illness or injury, I want the following support treatment: (check ONE that best describes your wishes): Apply any life support treatments my physician recommends.
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How to fill out my plan - hospice:

01
Start by gathering all necessary information and documentation related to your medical history, current health condition, and any specific wishes or preferences you have for your end-of-life care.
02
Consider consulting with healthcare professionals, such as your primary care physician or hospice care provider, to ensure you have a comprehensive understanding of what should be included in your plan.
03
Begin by identifying your healthcare proxy or durable power of attorney for healthcare. This person will be responsible for making medical decisions on your behalf if you are no longer able to do so.
04
Clearly specify your preferences for the type of care you desire, including whether you prefer to receive hospice care at home, in a hospice facility, or in a hospital.
05
Outline your preferred pain management and symptom relief methods, as well as any religious or cultural considerations that may affect your care.
06
Include details about your preferred goals and priorities for your end-of-life care, such as whether you prioritize comfort, quality of life, or specific medical interventions.
07
Consider including specific instructions regarding resuscitation, do-not-resuscitate orders, and other life-sustaining treatments you may want or wish to avoid.
08
Review and update your plan regularly, particularly if there are any significant changes in your health condition or personal circumstances.

Who needs my plan - hospice?

01
Your primary care physician or healthcare provider will need your plan to have a clear understanding of your end-of-life care preferences and goals.
02
Your designated healthcare proxy or durable power of attorney for healthcare will need your plan to understand their role and responsibilities in making medical decisions on your behalf.
03
Your family members or loved ones should also have access to your plan, so they can advocate for your wishes and ensure they are being honored.
04
Hospice care providers will require your plan to deliver appropriate care and support tailored to your needs and preferences.
05
If you have any legal arrangements in place, such as living wills or advanced healthcare directives, these documents should be updated and aligned with your plan to ensure consistency across different aspects of your end-of-life care.
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Your plan for hospice care involves outlining the services and treatments you wish to receive in order to maintain comfort and quality of life in the final stages of a terminal illness.
Your plan for hospice care can be filed by you, your healthcare proxy, or a legal guardian if you are unable to make decisions for yourself.
You can fill out your plan for hospice by discussing your wishes with your healthcare provider, selecting a hospice care provider, and completing the necessary paperwork.
The purpose of your plan for hospice is to ensure that your end-of-life preferences are honored and that you receive the care and support needed to remain comfortable in your final days.
Your plan for hospice should include details about your preferences for pain management, treatments, spiritual support, and any other specific wishes you have regarding your end-of-life care.
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