Advance Care Planning
Advance Care Planning is the process that allows you to make decisions about future medical care. It is a set of directions for the kind of medical care you want if you cannot communicate your wishes at some time in the future. About 50% of people will be unable to make decisions at some point in their lives. This can happen during a serious illness, after an accident, or near end-of-life. Loss of decision-making ability may be temporary or permanent.
Good advance care planning is an ongoing discussion about values, wishes, priorities and goals of care. It includes choosing a decision-maker who can represent you if you are unable to speak for yourself. This decision-maker is known as a Healthcare Agent. It also includes putting your specific wishes into writing using advance directives such as the Medical Durable Power of Attorney (MDPOA).
When you have completed your MDPOA and other advance directive documents, share them with your loved ones and medical providers. Please see MDPoA section below to download a physical copy of the form or to fill it out electronically in your MyBCH patient portal.
Advance care planning is not a requirement, but it is your legal right. Boulder Community Health encourages all adults to engage in this important process.
To help you begin or continue your advance care planning process, please review the sections below. BCH has made short videos that outline each step with links to relevant resources to accompany each video.
- How to Choose a Healthcare Agent
- How to Complete A Medical Durable Power of Attorney (MDPOA)
- How to Start Advance Care Planning Conversations
- Advance Care Planning in Serious Illness
- How to Talk to Your Medical Provider
- Medical Orders for Scope of Treatment (MOST)
- The Living Will
- COVID-19 Advance Care Planning
- Colorado End-of-Life Options Act and Medical Aid in Dying (MAiD)
- CPR Decision Aid
- Ventilator Decision Aid
- Advance Care Planning FAQ
How to Choose a Healthcare Agent
The American Bar Association offers this simple tool to help you decide between people when choosing a healthcare agent and alternates.
The The Conversation Project also offers a detailed guide on choosing a healthcare agent (also called a “proxy).
How to Complete a Medical Durable Power of Attorney
Choosing a healthcare agent and completing the MDPOA are important parts of advance care planning. In Colorado, there is no one who automatically becomes your agent when you don’t choose them yourself. If you don’t complete the MDPOA, and become unable to make your own decisions, all “interested” people gather and choose who the group feels would be best for the task. This means that anyone in your group of family, friends, and acquaintances could become your agent. There is no guarantee that the chosen person understands you and your values. Completing the MDPOA able helps you maintain control of your future.
Click here to watch our video on how to complete a Medical Durable Power of Attorney.
The Medical Durable Power of Attorney (MDPOA) form discussed in the video is commonly used and recognized throughout Colorado. There are many other forms available, and they are all valid. Remember—this form is legal without a notary or witness, but notarization is recommended if possible.
You may also fill out the MDPoA form in your MyBCH patient portal during the eCheck-in process for your clinic visit.
Click here for basic instructions on how to submit your MDPoA form.
How to Start Advance Care Planning Conversations
Clarify your healthcare values and prepare to talk about them with those that matter most using this simple Conversation Starter Kit. If you want something more detailed, use The Conversation Project Conversation Starter Guide.
Are you having difficulty introducing the topic of your end-of-life wishes? Click here to watch a funny video by The Conversation Project offers some great suggestions.
The simple and detailed Conversation Starter Guides are also available in Spanish.
Advance Care Planning in Serious Illness
If you have been diagnosed with a serious illness, it is time to revisit your advance care planning. Ariadne Labs and The Conversation Project offer the What Matters to Me workbook. This tool takes the Starter Kit a step further for people who are ready for more specific and near-term planning.
Return to TopHow to Talk to Your Medical Provider
Remember that talking to your medical providers about healthcare values and end-of-life wishes is an important step in the advance care planning process. They can help you understand various treatment options in the context of your unique health status. The Conversation Project offers a guide to help you start conversations with medical professionals.
Click here to watch a video on how to talk to your medical provider about advance care planning.
Medical Orders for Scope of Treatment (MOST)
The MOST Form can only be filled out in partnership with your medical provider. You can review a copy of the MOST Form here. The Center for Improving Value in Health Care (CIVHC) hosts Colorado’s MOST program and offers related information and education.
Click here to watch a video on What to Know About the MOST Form.
Return to TopThe Living Will
The Living Will is a legal document that summarizes your wishes about life-sustaining treatment in a narrow set of circumstances—if you are very near end-of-life or in a persistent vegetative state. It must be witnessed by two people to be valid. The linked form is widely recognized in Colorado, but there are many other forms available that are also valid.
Click here to watch our video on the living will.
COVID-19 Advance Care Planning
COVID-19 presents an opportunity to have very specific and focused advance care planning discussions. Consider your wishes if you were to become seriously ill with COVID-19 using The Conversation Project COVID-19 Discussion Guide. It is also available in Spanish.
Remember that treatments and outcomes for serious COVID-19 illness are changing frequently. These conversations will need to be re-visited on a regular basis.
Click here to watch our video on COVID-19 and advance care planning.
Return to TopColorado End-of-Life Options Act and Medical Aid in Dying
The Colorado End of Life Options Act was approved by Colorado voters in 2016 to allow medical aid in dying (MAiD). This means an eligible person with a terminal illness can receive a prescription for medication that they can choose to take to bring about a peaceful death.
Click here to watch a video on Medical Aid in Dying from The Conversation Project.
CPR Decision Aid
CPR stands for cardio-pulmonary resuscitation and it is used to try and restart a person’s heart when it has stopped beating. It is standard practice for health care workers to do CPR unless the person has a written record saying that they do not want CPR done if their heart stops.
Please read the forms below and think about your goals when deciding whether you would want to have CPR if your heart stopped beating.
CPR Decision Aid form - English
CPR Decision Aid form - Spanish
Ventilator Decision Aid
A ventilator is a machine that breathes for a person when they cannot breathe on your own. It is standard practice in the hospital to put a person who can’t breathe on a ventilator unless the person has chosen not to have one.
Please read the forms below to learn more about ventilator aid.
Ventilator Decision Aid form - English
Ventilator Decision Aid form - Spanish
Advance Care Planning FAQ
What happens if I don’t choose a healthcare agent using the Medical Durable Power of Attorney?
In Colorado, there is not a “next-of-kin” line to choose a healthcare agent. In other words, your spouse or oldest adult child does not automatically become your healthcare agent. If a person does not choose their own Healthcare Agent using the MDPOA, and they become unable to make their own decisions, Colorado’s Proxy Law comes into effect. the medical team must gather everyone who might be interested in making the person’s healthcare decisions. This group must then choose one member to take on this role. If there is absolutely no one to take on the Healthcare Agent role, there is a law in Colorado that allows a physician to make healthcare decisions.
If the group cannot come to an agreement regarding your medical treatment, proceedings for legal guardianship may be started. This is a lengthy legal process that is certain to cause delays and confusion about medical decisions.
I don’t have anyone to be my Healthcare Agent. Where can I find help?
Try to think “outside of the box” to find Healthcare Agent possibilities. Do you have a friend or neighbor that might be willing to help? Do you belong to a Faith Community or club with someone who might help? There are local professionals who will take on the health care agent role for a fee.
What if I want to change my advance directives?
You may change your advance directives at any time by completing new ones and destroying the originals or adding dated addendums. Ensure that your Healthcare Agent, medical providers, and loved ones know you have made changes and have copies of the most recent documents. It is very important to have conversations with everyone involved in your care when you are thinking differently about your choices.
Is there a place to have a Do Not Resuscitate (DNR) bracelet made?
There is a company in Denver, called Award & Sign that makes DNR bracelets and necklaces that are backed up by a signed DNR order. To obtain one of these bracelets, you send in a signed copy of your DNR order or MOST Form to the company. They make the bracelet and send it back to you. Click here to learn more.
What is the Colorado End-of-Life Options Act?
In 2016, Colorado passed legislation that allows medical aid in dying. This is called the Colorado End-of-Life Options Act. The law outlines the process for a terminally ill individual to follow if they wish to end his or her life in a peaceful manner.
How can I become an organ donor?
Any Living Will, Medical Durable Power of Attorney and CPR Directive may include a written statement indicating a decision regarding organ and tissue donation. Organ donation may also be accomplished by signing a separate document executed in accordance with the provisions of the “Uniform Anatomical Gift Act”. You should consult your health care provider for specifics. You should also notify your family of your decision to give an anatomical gift.