My Care, My Choice, My Voice. It's Never Too Early.
Have you spoken to your patients about advance care planning? You play an important role in helping your patients document their wishes.
Start the conversation today. Here are some suggested conversation starters:
- What happens if you cannot speak for yourself?
- Who will speak for you if you cannot?
- How would you choose to live and be cared for in the future?
- Have you ever written down your health care wishes?
- Do your family members or loved ones know your health care wishes?

Are you billing for advance care planning?
Encourage your patients to identify their values, beliefs and wishes. Help them understand how those translate into their future care. Take the time to discuss their quality of life wishes.
Part of the free Durable Power of Attorney for Health Care form is choosing your health care decision maker. Discuss how to choose a health care decision maker – someone they trust to speak on your behalf if they cannot.
Wishes are not set in stone. Patient’s views, beliefs and wishes may change – so can their free Durable Power of Attorney for Health Care form. It’s also important to revisit this conversation with your patients to make sure their form lines up with their wishes.
You play a vital role in this process. Ensure patients have a clear understanding of their wishes and direct them to complete a free Durable Power of Attorney for Health Care form.

Make sure your patients know to share wishes with their family, friends, doctors and caregivers.
Instruct them to keep an extra copy of their free Durable Power of Attorney for Health Care form in an easily-found location. Tell them to keep a copy in a folder attached to the refrigerator. If an event should take place at their home, emergency personnel are familiar with looking at the refrigerator for important documents.
It’s important to revisit this form with your patients on a regular basis. Make sure their wishes are in line with their form.
Be sure to upload a copy of their completed advance care form to your electronic medical record (EMR).

Helpful Resources
- Rhode Island Department of Health:
- Rhode Island Durable Power of Attorney for Health Care form:
- Cultural Perspectives on Death
- End of Life Issues: The Catholic Perspective:
- My Care, My Choice, My Voice:
- Prepare for Your Care:
- The Conversation Project
- American Bar Association Consumer Toolkit for Advance Care Planning
Learning Opportunities
- Massachusetts Medical Society: End-of-Life Care Course Series (Online CMEs)
MOLST
Health Care Proxy & Forms
- Health Care Proxies and End of Life Care
- Health Care Proxy Instructions & Document in 9 languages
- Getting Started Tool Kit
Support & Information
POLST & Advance Directives
- Legal Services for the Elderly: Advance Directives Forms
- Everplans Maine Advance Directive
- Maine Hospice Council & Center for End-of-Life Care: Advanced Health Care Planning Resources
- Maine Hospice Council & Center for End-of-Life Care: Hospice and End-of-Life Care Resources