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What’s in Your Health Care Plan?

Every competent adult can make his or her own Health Care Plan. Talk with your family and care providers about your choices for care. You can write down your choices in the 5 Massachusetts planning documents:

 

•  Health Care Proxy
•  Personal Directive or Living Will
•  Durable Power of Attorney
•  Medical Orders for Life-Sustaining Treatment (MOLST)
•  Comfort Care/Do Not Resuscitate Order (CC/DNR)

STEP 2: PLAN

Here are the 5 planning documents we use in Massachusetts. Your personal health care plan may include some or all of these legal, personal, and medical documents- it's your choice. You can start to make a plan at 18 years old, and add and revise documents as you like all through your life. It’s generally recommended that a basic plan include a Health Care Proxy, a Personal Directive (Living Will), and a Durable Power of Attorney for the best protection of your rights and choices under Massachusetts law.

START by completing a Massachusetts Health Care Proxy and a Personal Directive. You can use the documents provided below or other valid documents.*

Health Care Proxy

A Health Care Proxy is a legal document in which you appoint a person you trust to be your Health Care Agent. Your Health Care Agent talks with your doctors and makes health care decisions for you, if your attending physician determines in writing that you are unable to make effective health care decisions for yourself. You can complete a Health Care Proxy yourself. Download a free copy in English.

 

Read more “Things to Know About a Health Care Proxy” and “Things to Know About Choosing a Health Care Agent”.

Personal Directive

A Personal Directive is a personal document or statement in which you give your Health Care Agent information and instructions about your preferences and choices for health care. A personal directive, also commonly known as a Living Will, is not legally binding in Massachusetts but gives your Health Care Agent essential information about the kind of care you want if you become unable to make effective health care decisions yourself. You can complete a Personal Directive yourself. Download a free documents below.

 

Read more “Things to Know About a Personal Directive” and “Things to Know about Life-Sustaining Treatment

Durable Power of Attorney

A Durable Power of Attorney is a legal document in which you appoint a person you trust, called an Attorney-in-fact, to manage your money, property and financial matters if you become disabled or incapacitated and are unable to effectively manage your financial matters yourself. A Durable Power of Attorney is usually completed with the help of an attorney.

Medical Orders for Life-Sustaining Treatment (MOLST)

MOLST is a medical document that communicates your decisions about a range of life-sustaining treatments to your health care providers across treatment settings. MOLST is intended to be introduced to you by your clinician when you are seriously ill and takes effect immediately. A MOLST  is completed by you (or a Health Care Agent) and your clinician.

 

Click to download a sample MOLST form.

Comfort Care/ Do Not Resuscitate (CC/DNR)

A Comfort Care/Do Not Resuscitate form is a medical document that verifies you have a Do Not Resuscitate (DNR) order in effect. A CC/DNR form allows emergency medical service (EMS) personnel to provide comfort measures but not to attempt resuscitation if your heart or breathing stops. A CC/DNR is completed by you (or a Health Care Agent) and your clinician.

 

Other Documents

You can add other legal, personal or medical documents as you like to your plan. For example, you may choose to add a personal letter or video, other medical documents, or estate planning documents such as a Will or Trust.



What’s Next?  Create a ‘My Health Care Plan’ folder

Create a folder or a safe place to keep your original documents that is easily accessible so you can make copies as needed and review and revise your documents anytime. When you have completed a document:

  • Make a copy of your Health Care Proxy and Personal Directive for your Agents and doctors and care providers.
  • Make a copy of your Durable Power of Attorney for  your Attorney-in-fact. Remember, this document does not typically go into your medical record. It is a private legal document regarding your financial affairs. Your doctors and care providers do not need a copy in order to provide good care.
  • Make a copy of your MOLST or CC/DNR form for your Agents and your doctors and care providers.

Each time you add to your personal plan, move into Step 3: Connect to put your plan into action with your doctors and care providers.



* Terms of Use

 

Honoring Choices offers the Health Care Proxy Instructions and Form and the Personal Directive Instructions and Form at no cost to the consumer. We grant permission to download, print, and reproduce the documents in their entirety so long as the source and footer information are included. Click here to read full Terms of Use.