Advance Directive & Advance Care Planning

There may be a time when you are unable to make your own healthcare choices. Examples include a serious illness or an injury, such as a serious brain injury from a car accident. In these situations, someone else will have to make healthcare decisions for you. 

Advance Care Planning (ACP) is a process for you to:

  • Understand possible future health choices
  • Reflect on these choices in light of the values and choices important to you
  • Discuss your choices with those close to you and health professionals who care for you
  • Make a plan for future healthcare situations, including who will make choices for you. This plan is written on an Advance Directive to be shared with your healthcare team, your loved ones and the person who will make decisions for you. 

Effective Planning

This allows your choices to be known and will guide decision making. This process will provide great comfort to those who make decisions for you. Purposeful and ongoing ACP gives you peace of mind that your wishes are known.

Submit your Advance Care Planning Documents

Mail a copy to:

Advance Directive at Intermountain Healthcare
P.O. Box #571069
Murray, UT 84157

Email a copy as an attached document to: advancedirective@r1rcm.com

Complete your Advance Directive digitally with MyHealth+

Fax a copy to: 801-903-1619 Attn: Advance Directive at Intermountain

Bring a copy: to your provider’s office

Frequently Asked Questions

blank

Additional Information

More
blank

Why is it helpful to participate in advance care planning?

Why is it helpful to participate in advance care planning? Participating in advance care planning gives you the opportunity to talk to your family or those closest to you, as well as your health care provider(s) about future medical care. After these discussions, your preferences can be written down and a trusted person identified to serve as your healthcare agent to make decisions for you if you are unable to do so. A written directive provides clarity and peace of mind, prepares your healthcare agent for the unexpected and avoids confusion when the time comes where you cannot make decisions for yourself.
More
blank

Why do I need a Healthcare agent?

In a medical emergency the people who are providing your care do not know you. They do not know your history, your goals or wishes for care. Having a trusted and strong healthcare agent who can speak on your behalf is important. They can advocate for you and help make difficult decisions based on the conversations you have had with them before an event occurs.
More
blank

What are the types of decisions that my healthcare agent would be asked to make for me?

  • Signing for release of your medical records and personal files 
  • Applying for Medicare, Medicaid, or other programs for you 
  • Arranging for your admission to a hospital, hospice, or nursing home 
  • Giving consent or refusing medical services for you such as tests and surgery •
  • Making the decision to request, take away, or not give medical treatments
More
blank

Who cannot be a witness on an advance directive?

  • Anyone younger than 18 years old
  • The person named as the healthcare agent in the advance directive
  • Any person related by blood or marriage
  • Any person that may inherit from your estate
  • Any person responsible for your healthcare – financially or as a caregiver
More
blank

What are common mistakes made when filling out an advance directive?

  • Technical errors or gaps (i.e.: filling information out on the wrong line or in the wrong section)
  • Vague statements that are hard to interpret (i.e.: “Don’t use any tubes to keep me alive”, “I don’t want to be a vegetable”, “I don’t want any heroic measures”.) 
  • Missing signatures and/or dates (date signed, date of birth, etc…)
More
blank

What happens if I don’t have an advance directive?

If you become sick or injured and cannot communicate for yourself, health care providers will make treatment decisions based on what they believe are your best interests. This could include treatments that you might want or might not want. If you feel strongly about certain types of treatment that you would not want to receive, then an advance directive is a good way to communicate your preferences.
More
blank

Do I need a lawyer to fill out an advance directive?

No. You can fill them out yourself. Once you have filled out the forms, all you have to do to make them legal is sign them in front of the proper witness. You do not need a notary public.
More
blank

What is the difference between an Advance Directive and POLST/POST?

A POLST (Physician Order for Life Sustaining Treatment) is a medical order that healthcare workers, including EMS, can base their actions on. This portable medical order allows patients who are seriously ill or frail to voluntarily approach end of life planning in a way that honors and documents their wishes. It helps Emergency responders to have a quick and clear document to refer to without having to look through an entire Advance Directive. A POLST does not replace an Advance Directive. They work together. If you have a POLST form, you should be sure your Advance Directive reflects your same choices for care. A completed and signed POLST form is highly recommended if you wish to be DNR (Do Not Resuscitate) or no cardiopulmonary resuscitation (CPR). Your documents should be posted in a visible place in your home, often on the refrigerator, near your phone or at the bedside of a person who is mostly bedbound.
More
blank

Can advance directives include information regarding cultural or religious beliefs that are important to me?

Yes, these are your wishes. We suggest you consider the important role that culture, beliefs and values play in determining what you would want for future medical care and be sure to include this in your conversations and in your document.
More
blank

What happens if I change my mind about what I want after I have completed the advance directive form?

What happens if I change my mind about what I want after I have completed the advance directive form? We recommend you review and update your advance directive annually, or if one of the “four D’s” occurs: Diagnosis, Deterioration, Divorce, Death of a Healthcare Agent. You can change your mind at any time and update or revoke your Advance Directive. This is always about what you want. The important thing to remember is to give your updated form to those who have access to your previously completed documents (i.e.: doctor, hospital, healthcare agent, family, etc.).
More
blank

When will my advance directive be used?

The advance directive will only be used when you cannot speak for yourself.
More
blank

Do doctors, nurses and hospitals have to follow my instructions?

Healthcare providers are interested in honoring your wishes. They will make every effort to know and understand your wishes. There may be times when some of your preferences (i.e.: music playing in room, massage, essential oils, etc.) might not be possible.
More
blank

Will my advance directive and preferences be honored if I go out of state?

All 50 states (and the District of Columbia) generally recognize the use of advance directives. When you travel, you should bring copies of your health care documents or take a picture on your phone to make them easily accessible if an accident or unexpected illness occurs.
More
blank

Who should have a copy of my advance directive?

  • Your primary care provider (such as your family doctor)
  • Any family members who may need to know how to contact your advocate in the event of an emergency
  • The individuals that you have chosen to be your successor advocate(s)
  • Your closest hospital (wherever you would go for emergencies) 
  • Other medical facilities (such as hospitals or nursing homes) where you frequently receive treatment, or upon being admitted for a major procedure, such as surgery.
More
blank

What if English is not my primary language?

If English is not your primary language, please ask your doctor to provide an interpreter to assist you in understanding and completing your advance directive.
More