Advance Care Planning and Advance Directives

Overview

What is advance care planning?

Advance care planning refers to when you think ahead about what your health care wishes would be if you were unable to speak for yourself at any time in the future, and communicate those wishes to your loved ones and your medical team. Advance care planning is important for people of all ages because anything can happen to anyone at any time like an accident or a stroke, and having a plan in place can help ensure that your healthcare wishes can be known and honored in any situation. Advance care planning is a gift you give to your loved ones.

What are advance directives?

Advance Directives are legal documents that provide instructions about your healthcare wishes, in case you are unable to make healthcare decisions for yourself.

There are two primary types of Advance Directives in the state of Ohio, (1) Health Care Power of Attorney and (2) Living Will.

• A Health Care Power of Attorney is a type of Advance Directive in which you name a person to make healthcare decisions and speak for you when you are unable to speak for yourself, either permanently or temporarily (i.e., under general anesthesia, under sedation, unconscious, in a coma or a delirium, etc.). This person can be a family member, a friend, your spouse (opposite sex or same sex), domestic partner (opposite sex or same sex), or someone you trust.
• A Living Will is a written set of instructions regarding your preferences for healthcare at the end of life and goes into effect if you are terminally ill and unable to make decision for yourself, or if you are permanently unconscious.

View the About Advance Directives brochure.

As long as you are able to make your own health care decisions, the documents will not be used.

FAQs

Can I choose my own medical care based on my values, beliefs and personal choices?

You have the right to choose your own medical care based on your values, beliefs and personal choices. You have the right to complete advance directive documents, at no charge, as long as you understand your options and can communicate them in front of witnesses OR a notary.

Do I have to complete advance directives?

Cleveland Clinic recommends that every adult have an advance directive in their electronic medical record and have conversations with their loved ones about their wishes. We suggest using The Conversation Project to prepare for these conversations.

While we recommend that all adults complete advance directives, they are not required and are always optional. You have the right to NOT complete advance directive documents. You may also choose to complete only one of the forms, and add the other documents when you are ready to make those decisions.

Advance directives are especially important if:

• Your caregiver or health care representative is not your legal next of kin.
• You have multiple next of kin; OR
• You have specific medical wishes due to a medical condition, religious affiliation or family situation.

What happens if I do not have Advance Directives and I become unable to make decisions by myself?

The law recognizes an Order of Decision Makers if you are unable to make healthcare decisions for yourself and you do not have a Health Care Power of Attorney document. If the state has appointed a guardian, this person is the first decision maker. If not, the Order of Decision Makers for Ohio and Florida, according to the law, are:

• Spouse.
• Adult children (majority of).
• Parents.
• Adult siblings (majority of).
• Or other nearest relative.

For Florida only, not Ohio: A close friend who has exhibited special care and concern for you and who is familiar with your activities, health, and religious or moral beliefs can also be used if no one from the above list is available.

How can I complete an advance directive?

Any person over age 18 who can make his or her own decisions can complete an advance directive form. You do not need a lawyer to complete advance directive forms. However, the forms need to be signed by a notary or two witnesses. The witness may include anyone except your attending physician, any person related by blood, marriage or adoption, the person(s) you name as decision maker (your agent) in the Health Care Power of Attorney document, or the administrator of a nursing facility where you are a resident.

• Download the patient guide.

Why is it recommended to have an Advance Directive if I am married and my spouse will make decisions?

In the Health Care Power of Attorney document you will be able to name an agent and also alternates in case the first person is not available.

What if I want to make a change to my forms?

You may revise advance directive forms at any point by completing new ones. Any changes should be written, signed and dated in accord with state law, and copies should be given to those who had copies of your previous documents.

The latest version of your form is the one that will be followed. We also recommend you to review and revise your document as necessary:

• At least every 5 years.
• At significant life events such as: divorce, death of a loved one, when your children turn 18 years old, at the time of the diagnosis of a new health condition.

Can my domestic partner (opposite sex or same-sex) be my legal surrogate for healthcare decisions?

Yes, but only if you appoint him/her as your healthcare agent in a healthcare power of attorney.

How about if I am separated but not divorced? Is my spouse able to make healthcare decisions for me?

Yes, if you do not have a healthcare power of attorney in place, your spouse is the first alternate decision-maker per law in Ohio.

Forms: English/Other Languages

Ohio Advance Directives forms in English:

• Download and complete the Ohio Advance Directive Forms packet that includes the health care power of attorney, living will, donor registry enrollment and instructions.
• For more information on stating your wishes regarding medical treatment, download the Cleveland Clinic’s Advance Directive Informational brochure.
• Health Care Power of Attorney and Living Will Completion Guide.

Where can I get advance directives forms in other languages?

Arabic

• Download and complete the Ohio Advance Directive Forms packet that includes the health care power of attorney, living will, donor registry enrollment and instructions.

Cantonese

• Download and complete the Ohio Advance Directive Forms packet that includes the health care power of attorney, living will, donor registry enrollment and instructions.

Mandarin

• Download and complete the Ohio Advance Directive Forms packet that includes the health care power of attorney, living will, donor registry enrollment and instructions.

Russian

• Download and complete the Ohio Advance Directive Forms packet that includes the health care power of attorney, living will, donor registry enrollment and instructions.

Spanish

• Download and complete the Ohio Advance Directive Forms packet that includes the health care power of attorney, living will, donor registry enrollment and instructions.
• Health Care Power of Attorney.
• Living Will.

If you are physically at one of our locations, you can also request the forms from any Registration, Care Management or Spiritual Care department.

What if I live outside of Ohio or Florida?

Advance Directives are intended to be honored in any state, but the laws vary by state. It is suggested that you complete the document for the state you primarily reside in. However, if you are receiving medical care in another state, it would be helpful to verify that your documents will be valid there.

What do I do with my forms after I complete the documents?  

After you complete the forms, talk to those people who may be involved in your healthcare decision making, and give them a copy of your forms to make sure your wishes are followed. Remember to include loved ones, family members and your healthcare providers so they know about your wishes.

We encourage you to have a copy of your advance directives placed in your medical record at Cleveland Clinic. You can do so in any of the following ways:  

In Person:
Bring the document(s) to your next appointment.  

Through MyChart:
Submit your document(s) using the Advance Care Planning feature in PDF format.

By Email:
Send your document(s) to advancedirectives@ccf.org as an attachment in PDF format.

By Mail:
Cleveland Clinic
Health Information Management, Ab7
Advance Directive Processing
9500 Euclid Ave.
Cleveland, Ohio 44195-9905

By Fax:
216.445.9733

Please note: You can use this address or fax number regardless of which Cleveland Clinic hospital you utilize, and we will make sure it is filed appropriately.

How can I verify that my document is in my medical record?

You can either check in your medical record using MyChart (after logging in to MyChart, within the Health menu, click on My Document Center then on My Documents. Click on Advance Directives to view documents that are on file), or you can ask a caregiver at any of our Cleveland Clinic Registration desks.

Florida Advance Directives

Note: For better quality when printing, select the setting option to “fit” the document onto the page. Two-sided printing is optional.

Cleveland Clinic Weston Hospital and Cleveland Clinic Martin Health

• Advance Directives Brochure (English, Spanish, Creole).
• Designation of Health Care Surrogate (English, Spanish, Creole).
• Living Will (English, Spanish, Creole).

Cleveland Clinic Indian River

• Advance Directives Brochure (English, Spanish, Creole).
• Designation of Health Care Surrogate (English, Spanish, Creole).
• Living Will (English, Spanish, Creole).

Questions?

The advance directives forms are easy to complete and we are here to help you. Please talk to your social worker or a member of your hospital’s Spiritual Care Department if you need help completing the forms. There are also some cultural and religious-specific forms available that meet Ohio state laws, so please ask for more information.

If you have questions or need additional assistance, please call the number listed below for your hospital.