Planning for Deterioration: A Beginner-Friendly Start
Planning for Deterioration: the few things that matter most, and the mistakes that catch people out early.
Deciding in advance what should happen if a condition worsens.
Key takeaways
- Living will: records which treatments you would or would not want
- Health care power of attorney: names someone to make medical decisions if you cannot
- Most useful single change: Discuss wishes with family and your care team, not only on paper.
- Commonest mistake: Assuming a spouse or relative can automatically decide for you.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
Decisions get made either way, and planning is the only way they are made by the person they concern.
Start here
Two things, and nothing else until both feel routine.
- Discuss wishes with family and your care team, not only on paper
- Name a health care agent while you can clearly decide
Then add these
After that, these.
- Keep documents accessible and give copies to your doctor and agent
- Review your documents after any major diagnosis or hospital stay
The numbers, in one place
| Measure | Figure |
|---|---|
| Living will | records which treatments you would or would not want |
| Health care power of attorney | names someone to make medical decisions if you cannot |
| Portable medical orders (POLST) | signed medical orders for emergency care, for people with serious illness |
| State law | forms and requirements vary by state |
| Medicare | covers advance care planning conversations with your doctor |
Common early mistakes
- Assuming a spouse or relative can automatically decide for you
- Leaving it until you can no longer decide
- Using a form from a different state without checking it is valid where you live
Related topics
- Planning Ahead: What the Evidence Actually Says (Healthy Aging)
- The Evidence on End of Life Caring, Without the Hype (Carers)
- Flare Management: What the Evidence Actually Says (Chronic Pain)
- Hurricane Preparedness and Emergency Kits: Sorting the Evidence From the Noise (Heat, Cold and Weather Safety)
Where to go next
- Myths About Planning for Deterioration, Checked Against the Guidance
- Answers to the Common Questions on Planning for Deterioration
- Planning for Deterioration — the reference entry
- Long-Term Conditions: The Complete Guide
- What the Guidance Really Says About Living with Multiple Conditions
- Self-Management: What Published Guidance Supports
When to speak to a doctor
Talk to your doctor about advance care planning, particularly after a serious diagnosis or hospital stay. Advance directives must meet your state's legal requirements to be valid — use your state's forms or take advice rather than relying on a handwritten note. In an emergency, call 911 and give responders any POLST or directive you have.
Where this comes from
- National Institute on Aging — Advance Care Planning: Advance Directives for Health Care
- MedlinePlus — Advance Directives
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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