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Advance Health Care Decision Making

Planning ahead for physical and mental incapacity is an important issue for all of us. Utah law provides suggested forms and instructions for advance health care directives and the appointment of an agent to make health care decisions for an adult who loses the capacity to communicate. You can link to Utah’s forms and more information at http://aging.utah.edu/utah_coa/directives/ , or directly from the court website at http://www.utcourts.gov/howto/seniors/#Advance.

The Utah Division of Aging and Adult Services provides information and forms about advance health care decision making including a very useful Tool Kit that helps people think through their wishes and how to express them in meaningful ways. Go to http://www.hsdaas.utah.gov/advance_directives.htm

Utah law also provides for a mental health directive to help people with mental illness plan ahead for such tough decisions as commitment to treatment and medications. Go to more information on the Nami Utah Web site at http://www.namiut.org/index.php?option=com_content&task=view&id=62&Itemid=52, or view Utah’s laws and sample Declaration for Mental Health Treatment form at Utah Code 62A-15-1001 to 1004, http://le.utah.gov/UtahCode/section.jsp?code=62A-15.

On the national front, the Secretary of Health and Human Services sent a comprehensive report to Congress this week entitled “Advance Directives and Advance Care Planning.” The report, requested by Congress in 2006, focuses on (1) the best ways to promote the use of advance directives and advance care planning among competent adults as a way to specify their wishes about end-of-life care; and (2) addressing the needs of persons with disabilities with respect to advance directives. You can link to the report at http://aspe.hhs.gov/daltcp/reports/2008/ADCongRpt.htm. It includes an excellent literature review on every aspect of advance care planning, analyses of key ethical and legal issues, and a discussion of opportunities to enhance the effectiveness of advance care planning and advance directives.
The report is particularly timely as health care reform is in the public policy forefront, and several bills are pending in Congress regarding advance care planning and improving care near the end of life.

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