Talking about the type of care you do – or don’t – want when you can’t speak for yourself can be daunting. Called, “advance care planning (ACP)” these conversations with loved ones are often difficult to initiate. Until recently, Indiana laws and forms added to that difficulty with conflicting, outdated statutes and forms. Thankfully, several major revisions were instituted in the 2021 legislative session.

ACP is the process of preparing for future medical decisions by first discussing and then documenting your values and choices, including choosing a health care representative. This is the person who would speak for you if you could not speak for yourself in a medical crisis. Would they know your wishes? Would they remember them in a stressful situation? Being able to capture these decisions in an accessible format allows for less-stressful decision making.

Indiana advance directives statutes were overdue for an update for a number of reasons. Some of these included:

• The living will used outdated language and all-or-nothing options.
• There were two legal methods of appointing a healthcare representative which created confusion and redundancy.
• COVID-19 demonstrated that signing documents “in the direct presence” of witnesses is not always possible.

State legislators, the Indiana Patient Preferences Coalition and others collaborated to address these difficulties. Revisions include:

• The new law establishes guidelines rather than static forms, allowing for flexibility in recording treatment preferences.
• A broad range of treatments can now be documented rather than answering yes or no to only one or two options.
• The new health care representative (HCR) role combines HCR and power of attorney with greater clarity of the role. The authority of the HCR was expanded when acting on behalf of a patient, such as the right to sign a physician’s order for scope of treatment (POST) form.
• Greater signing flexibility when people are not in the same physical location.

So, does this mean that my current forms are no longer valid? Fortunately, no – previously completed forms remain in effect with no expiration date. While new forms are not required, most advance care planning organizations, such as Honoring Choices Indiana – North Central (HCI-NC), recommend that all advance directives be reviewed every five to ten years to address changes in life situations and preferences.

While Indiana will no longer issue official forms the Indiana Advance Directives Resource Center will offer links to examples of forms that meet the guidelines. One of these can be downloaded at www.prepareforyourcare.org by entering your state and downloading a PDF.

HCI-NC provides up-to-date information about ACP legislation as well as assisting with the conversation and completing forms – all at no charge. Contact the organization at info@hci-nc.org to learn more.