Get the free My Advance Care Plan

This document serves as an advance care plan, outlining an individual\'s preferences for future care, important contacts, and personal wishes regarding health and end-of-life decisions in the context of dementia care. It includes sections on personal details, proxies, preferred places for care and death, advance decisions, and funeral arrangements.

How to fill out my advance care plan

How to fill out my advance care plan

1. Start with your personal information: Include your name, date of birth, and contact information.
2. Identify your healthcare agent: Choose someone you trust to make decisions on your behalf if you're unable to do so.
3. Specify your medical wishes: Clearly outline your preferences for medical treatment and interventions.
4. Discuss your end-of-life care: Include preferences for hospice care, resuscitation, and life support.
5. Review and sign the document: Ensure that all required signatures are obtained, along with any necessary witnesses or notarization.
6. Distribute copies: Share your advance care plan with your healthcare agent, family members, and relevant healthcare providers.

Who needs my advance care plan?

1. Your healthcare providers need your advance care plan to understand your medical preferences and make informed decisions.
2. Family members and loved ones should have access to your advance care plan to ensure they can honor your wishes.
3. Your healthcare agent must have a copy to be prepared to advocate for you in medical situations.

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What is my advance care plan?

An advance care plan is a document that outlines your preferences for medical treatment in case you become unable to communicate your wishes.

Who is required to file my advance care plan?

Typically, the individual creating the advance care plan is responsible for filing it, although healthcare providers may also keep a copy in their medical records.

How to fill out my advance care plan?

To fill out your advance care plan, you should review options for medical treatments, discuss your preferences with family and healthcare providers, and complete the necessary forms outlining your wishes.

What is the purpose of my advance care plan?

The purpose of an advance care plan is to ensure that your healthcare preferences are known and respected, even if you are unable to communicate them yourself.

What information must be reported on my advance care plan?

Your advance care plan should include specific treatment preferences, appointing a healthcare proxy, and any values or goals that guide your healthcare decisions.