Resources for the Who's Your Agent?® Program
Every person can make a personal care plan
Make care choices starting with a simple conversation. See video.
Write down care choices in multi-lingual MA documents.
Update your plan for good care today and over your lifetime.
Step-by-Step Massachusetts Health Care Planning Process
Start with a simple conversation, and take the next step to make your personal plan!
The Massachusetts Health Care Planning Process is an easy to use guide to engage in important care planning conversations from simple to serious illness. The process includes the Honoring Choices structured approach to care planning and Ariadne Labs Serious Illness Conversation Guide.
The short video below shows you how to:
- Have a Conversation to make care choices (left side);
- Use the accompanying Planning Tools to write down your care choices (right side).
See Videos with Sub-Titles in:
Spanish
Portuguese (Brazil)
Chinese (Traditional)
For New Hampshire (NH) Residents: See the NH Planning Process adopted from the MA Planning Process and adding NH planning tools. Read more about NH process and tools here.
Start to Make Your Plan
A good place to start is choosing a Health Care Agent and completing a Health Care Proxy.
English
Spanish (Latin) Translation
Portuguese (Brazil) Translation
Traditional Chinese Translation
1. CHOOSE a person you trust, like a family member, a friend, or anyone you like to be your Health Care Agent.
- Talk to your trusted person about your care preferences. See video: Choosing a Health Care Agent.
2. WRITE the name of your Health Care Agent in the Health Care Proxy document.
- Print a free Health Care Proxy document below (in 15 languages).
- Fill out the document. See video: How To Complete an Honoring Choices Health Care Proxy.
- Give a completed copy to your Health Care Agent.
3. SHARE a copy of your Health Care Proxy with your doctors and medical care team to place into your medical record.
- Your medical team will contact your Health Care Agent in an emergency.
Once you completed your Health Care Proxy —
Make your own “I Have a Health Care Proxy” Wallet Card (in 4 languages below). It helps medical staff call your Health Care Agent in an emergency. Download below.
Getting Started and Next Steps Tool Kits
The tool kits align with the Health Care Planning Process (above) to make your own personal plan.
Getting Started Tool Kit
Start a simple conversation to make your own plan. The tool kit includes a Health Care Proxy and Personal Directive (Living Will), and a conversation guide.
- Name a Health Care Agent
- Appoint your Agent in a MA Health Care Proxy; document available in 15 languages
- Make your own "I Have a Health Care Proxy" Wallet Card
- Talk to important people about your care preferences
- Write down your instructions for care in a Personal Directive (Living Will) document
- Appoint a financial decision-maker in a Durable Power of Attorney; see fact sheet
- Talk with your care professionals about your goals & priorities
- Use the Consumer Conversation Guide 1 to Start a Simple Conversation To Stay Well, to get care that matches your goals and care prefernces.
Next Steps Tool Kit
Build on your conversations from simple to serious illness. The tool kit includes conversations guides and fact sheets so you can —
- Complete a Durable Power of Attorney (DPOA)
- You choose a trusted person to help manage your money, property, and financial matters if you become disabled or incapacitated.
- See the DPOA Fact Sheet here.
- Talk with your care professionals using our Consumer Conversation Guides to:
-
- Guide 2- Manage Chronic Illness
- Guide 3- Live Well with Serious Illness
- Guide 4- Palliative Care: an extra layer of support
-
- Start a MOLST Conversation for individuals with serious illness
- Talk with your health care provider to choose treatment options in a MOLST: Medical Order for Life-Sustaining Treatment; sample medical order and fact sheet
- End of Life Care planning tools; Hospice fact sheet and resources.
Download the Next Steps Tool Kit (PDF)
- Clinicians and Care Team Members can start early and on-going conversations —
- Download Care Provider Conversation Guides 2-4 (PDF) below; they mirror the Consumer Conversation Guides
- Ariadne Labs Serious Illness Conversation Guide
Adult and Supportive Person Tool Kit
Adults with a range of abilities can chose a supportive person to make a plan, and complete a simplified Personal Directive using both words and pictures. This tool kit can be used by any adult who would like to make plan with the help of a supportive person, including adults who do not have the capacity or ability to complete a Health Care Proxy and adults subject to or under a guardianship.
The adult makes care decisions and chooses a supportive person to help make a plan and assist the adult in getting good care. The 3-step guide makes it easy to —
- Step 1. Get health care information to make care choices
- The supportive person provides health information to the adult in any manner the adult can understand.
- List the ways the supportive person can help the adult in making care choices in a handy checklist.
- Step 2. Write down your care choices and preferences
- The supportive person helps the adult complete a Personal Directive using words and pictures.
- The Personal Directive documents the adult's likes and dislikes and ways the adult wants to be cared for.
- Step 3. Talk with your health care providers to get good care.
- The supportive person helps to communicate the adult's care preferences to their health care providers.
- List the ways the supportive person can assist the adult in getting good care and needed services in a handy checklist.
Personalize and Update Your Plan
Use the tool kits above to start your plan. You can personalize and update your plan using the information and tools below.
- How and when to use the 5 MA planning documents;
- Multi-lingual planning documents;
- "I Have a Health Care Proxy" wallet card;
- Handy conversation guide series;
- FAQs and Informational fact sheets.
5 Massachusetts Care Planning Documents
Read more about the planning documents we use in Massachusetts. Download informational fact sheets and forms on these pages.
Health Care Proxy
Choose a trusted Health Care Agent to make care decisions. Appoint in a Health Care Proxy.
Personal Directive (Living Will)
Write down what's important to you and instructions for the care you want.
Durable Power of Attorney
Choose a trusted person to make financial decisions for you and pay for the care you need.
Medical Orders for Life-Sustaining Treatment
Seriously ill patients talk with clinicians about their treatment decisions and document choices.
Comfort Care / Do Not Resuscitate Order
Seriously ill patients talk with clinicians about resuscitation and document choices.
Multi-lingual Documents, Wallet Card, Videos and Consumer Handout
Health Care Proxy
Visit Translated Documents or download Health Care Proxy in 16 languages below.
English - English
Español - Spanish
Português - Portuguese
Tiếng Việt - Vietnamese
Kreyòl Ayisyen - Haitian Creole
Kiswahili - Swahili
नेपाली - Nepali
简体中文 - Simplified Chinese
Tagalog - Tagalog
Русский - Russian
繁體中文 - Traditional Chinese
عربي - Arabic
ភាសាខ្មែរ - Khmer
Shqip - Albanian
Polish - Polski
Kabuverdianu - Cape Verdean Creole
Durable Power of Attorney Fact Sheet
- You choose a trusted person to help manage your money, property, and financial matters if you become disabled or incapacitated.
- See the DPOA Fact Sheet here.
Videos
Accessibility
- Screen reader accessible: use screen reader and fillable documents. Visit Screen Reader Accessible Documents
Personal Directive
Visit Translated Documents or downlolad Personal Directive in 5 languages below.
English - English
Español - Spanish
Português - Portuguese
Русский - Russian
繁體中文 - Traditional Chinese
Wallet Card
Visit "I Have a Health Care Proxy" wallet card or download in 7 languages below.
Español - Spanish
Português - Portuguese
繁體中文 - Traditional Chinese
Tiếng Việt - Vietnamese
Kreyòl Ayisyen - Haitian Creole
Kabuverdianu - Cape Verdean Creole
"Who is Your Health Care Agent? 1-page Consumer Handout
Print and distribute to all consumers statewide!
English - English
Español - Spanish
Português - Portuguese
Kreyòl Ayisyen - Haitian Creole
عربي - Arabic
Tiếng Việt - Vietnamese
繁體中文 - Traditional Chinese
ភាសាខ្មែរ - Khmer
Kabuverdianu - Cape Verdean Creole
Handy Conversation Guides
The Honoring Choices Consumer and Care Provider Conversation Guide Series offers 5 key topics to explore with sample questions to help you talk about your care goals and choices. The guides help you build on your conversations as your choices and health needs change.
The Consumer and Care Provider Guides mirror each other for more meaningful and effective conversations.
Honoring Choices Consumer Conversation Guides
5 Things to Talk About with Your Care Providers
Guide 1: Start a Simple Conversation to Stay Well
Guide 2: Managing Health and Chronic Illness
Honoring Choices Care Provider Conversation Guides
5 Things to Talk About with Your Care Providers
Guide 1: Start a Simple Conversation to Stay Well
Guide 2: Managing Health and Chronic Illness
Serious Illness Conversation Guides: Ariadne Labs and The Conversation Project
The Honoring Choices planning process and conversation guides works seamlessly with these serious illness conversation guides:
- For Health Care Providers: Ariadne Labs Serious Illness Conversation Guide
- For Consumers: What Matters To Me Workbook available in English, Spanish, Chinese; by Ariadne Labs and The Conversation Project.
Information and FAQs
Download Fact Sheets and Frequently Asked Questions
Capacity and Decision-Making
Caregivers
Care Planning: Health Care Planning vs. Advance Care Planning
Comfort Care/Do Not Resuscitate Order (CC/DNR)
Durable Power of Attorney
Guardianship
- What is Guardianship?
- Guardians' Role & Decision-Making Authority
Health Care Agent
Health Care Proxy
Hospice Care
Medical Orders for Life-Sustaining Treatment (MOLST)
- What is a MOLST and CC/DNR?
- Sample MA MOLST form
- EMS and MOLST: Things you can do ahead of an emergency!
Palliative Care
Personal Directive
Serious Illness Care
Supported Decision Making
Terms & Tips to Understand Health Care Planning
Who’s Your Agent? Program
Consumers and Care Provider Webinars
Gather your group; we'll provide an informational consumer presentation, and offer a care provider/staff training to confidently engage adults in simple to serious illness conversations.
Now's the Time! Make Your Own Health Care Plan
For consumer and community groups. We'll provide a fun and information virtual session to help every person start to make their own health care plan using the Getting Started Tool Kit. The tool kit includes a MA Health Care Proxy to choose a Heath Care Agent, a Personal Directive (Living Will) to give instructions about your care, and a handy conversation guide to start a planning conversation with your care providers. Learn more.
Engage Adults in Conversations from Simple to Serious Illness
For health care professionals & staff. Choose one or both of the virtual sessions:
- Become a Certified Health Care Planning Ambassador, using the Honoring Choices Getting Started and Next Steps Tool Kit
- Engage Adults in Seamless Conversations from Simple to Serious Illness, using Honoring Choices Tool Kits and introducing Ariadne Lab's Serious Illness Conversation Guide. Learn more.
Honoring Choices Partners: Working Together to Standardize Care Planning and Improve Health Outcomes
Simple Step: A Cross Continuum Care Planning Campaign
The MA Health and Hospital Association and a coalition of leading organizations across the care continuum, have come together to promote long term care planning starting by taking a simple step.
The Simple Step campaign helps patients/ consumers start a simple planning conversation to designate a Health Care Agent and complete a Health Care Proxy document
The coalition is highlighting three key steps for community members:
- Choose someone you trust to be your designated Health Care Agent, and have a simple conversation about how you want to be cared if you get sick and can make care decisions yourself;
- Complete a Health Care Proxy form to appoint your Health Care Agent– you can do it all yourself! The Honoring Choices MA Health Care Proxy is free, downloadable and available in 15 languages,
- Talk with your with your health care team about the care that’s right for you and place your Health Care Proxy in your medical record.
Resources:
- See the partner toolkit and patient resources here.
- Messaging you can adapt and Simple Step graphics
- Download the free Honoring Choices Health Care Proxy, available in 15 languages,
- View a short video- “Complete Your Own Honoring Choices Health Care Proxy”
Come Join us! All state, health care and community organizations across the care continuum are very welcome. We'll provide the process and tools to easily embed simple conversations into your everyday work.
Helpful Webpages
Who's Your Agent? for Care Providers
Our Who's Your Agent? Program for Care Providers and Professionals is a one-stop overview of our structured approach to health care planning. It has everything you need to confidently engage adults in conversations from simple to serious illness, and make a care plan for the best possible care. Read about the Program for Care Providers.
Serious Illness Care
Learn about serious illness care, how to have planning conversations, and consider a MOLST or CC/DNR form. NEW: the POLST Program coming soon. Read more about Serious Illness Care.
Palliative Care
Palliative Care helps people with serious illness have an extra layer of support to relive the pain, symptoms and stress of serious illness. Helps families too. Read more about Palliative Care.
Get Help In Your Community
Meet the Community Partners in 7 regions of the state. They can help you make a personal plan and connect you to care in your community. Find a Partner in your community.
New England Planning Documents
Download state-specific documents from Maine, New Hampshire, Vermont, Rhode Island and Connecticut. Read more about New England documents.
Lifetime Health Care Planning Roadmap
See how the health care planning works at every phase of health- from promoting everyday wellness, to managing health needs and chronic illness, and living well with serious illness. Read more about the Roadmap.