Advance Care Planning

Advance Care Planning (ACP) is a process for patients and their families to discuss their wishes and goals of care for treatment and end-of-life care, clarify related values and goals, and state preferences through written documents and medical orders. This process can start at any time and be revisited periodically but becomes more focused as health status changes. In situations where a patient's decision-making capacity is limited, healthcare providers turn to family members to make decisions. When there have been no ACP conversations between the patient and family, family members are left to make decisions regarding life-sustaining treatment without input from the patient or with little knowledge of the patient's wishes. 

Advance Care Planning Resources

There are many online resources available to assist with advance care planning.  Below are links to several resources that can help nurses create a plan. We encourage you to look through these resources, and choose the one that works best for you.

Advance Care Planning Decisions is a site offering videos and resources:
American Association of Retired Persons (AARP) offers basic resources on caregiving: 
American Bar Association offers a toolkit for health care advance planning:    
The American Cancer Society web site includes information about advance directives:
Begin the Conversation
is a site created by the Lower Cape Fear Hospice in Wilmington, NC:
Caring Info is a program of the National Hospice and Palliative Care Organization:  
The Centers for Disease Control publishes a list of selected resources for ACP:
The Conversation Project is an initiative of the Institute for Healthcare Improvement:  
Defining Hope is a documentary feature about people weighing what matters most at a critical time:  
Five Wishes is an easy-to-use legal advance directive document available in a variety of languages: 
My Directives offers both online and mobile app options for advance directives:
National Healthcare Decisions Day (April 16) -  National initiative that encourages individuals to express their wishes:
National Physician Orders for Life Sustaining Treatment (POLST ) Paradigm provides materials for planning:  
PREPARE For Your Care is a step-by-step program with video stories to help you prepare.
Respecting Choices is an internationally-recognized, evidence-based program that addresses the ACP process. 

Additional Resources

Below is a list of other resources related to advance care planning.