What is advance care planning?

Advanced care planning is the process of thinking about, discussing, and documenting your wishes for future medical care. It ensures that your values, goals, and preferences are known and respected if you are ever unable to speak for yourself due to illness, injury, or a medical emergency.

At Winner Regional Health, we believe advanced care planning is an important part of whole-person care. Taking time now to plan ahead can provide peace of mind for you and clarity for your loved ones and care team.

Why Advanced Care Planning Matters

You have the right to decide what medical treatments you do and do not want. Without written guidance, healthcare providers are required to turn to family members to make decisions on your behalf. This may result in decisions that do not reflect your wishes or values.

Advanced care planning helps you:

- Maintain control over your medical decisions

- Reduce stress and uncertainty for family members

- Ensure care aligns with your personal beliefs and goals

- Prepare for unexpected illness, injury, or end-of-life situations

What is an Advance Directive?

An advance directive is a legal document that communicates your healthcare wishes if you are unable to make decisions for yourself. In South Dakota, an advance directive may include:

Durable Power of Attorney for Health Care

This document allows you to name a healthcare agent—someone you trust to make medical decisions on your behalf if you are unable to do so. If you regain the ability to make decisions, your authority is restored.

Living Will

A living will outlines the types of medical treatment you wish to receive or avoid if you are terminally ill, near death, or permanently unconscious. It only takes effect when you are no longer able to communicate your wishes.

Advance directives do not require an attorney, but they must be properly signed, witnessed, and, in some cases, notarized to be valid.

Medical Orders and How They Differ

Advance directives express your wishes, while medical orders translate those wishes into actionable instructions for healthcare providers.

MOST (Medical Orders for Scope of Treatment)

A MOST form is a portable medical order for patients diagnosed with a terminal condition as defined by South Dakota law. It is completed through discussion with your medical provider and reflects your goals for care, including:

Cardiopulmonary resuscitation (CPR)
Use of life-sustaining treatments
Artificial hydration and nutrition
Hospice care

To be valid, a MOST form must be signed by both the patient and the medical provider and is entered into the medical record.

Comfort One

Comfort One is a Do Not Resuscitate (DNR) medical order recognized statewide in South Dakota. It allows emergency personnel to quickly identify individuals who choose not to receive life-prolonging treatments and instead receive comfort-focused care. Patients typically wear a Comfort One bracelet or carry documentation.

Emergency medical services can only honor treatment limitations if a MOST or Comfort One form is in place.

Important Things to Know

CPR (Cardiopulmonary Resuscitation): Emergency measures such as chest compressions, medications, and electric shocks used to attempt to restart the heart.

DNR (Do Not Resuscitate): A medical order indicating that CPR should not be performed if the heart stops.

Allow Natural Death (AND): Focuses on comfort and symptom management rather than aggressive life-prolonging treatment.

Artificial Hydration and Nutrition: Delivery of fluids and nutrients through medical methods when a person cannot eat or drink.

Hospice Care: Supportive care focused on comfort, quality of life, and symptom management for individuals with a terminal illness.

Getting Started with
Advanced Care Planning

When creating your plan, consider how you would want care handled in these situations:

- A sudden illness

- A severe accident

- A terminal condition

Helpful questions to ask yourself include:

- Do I want aggressive medical treatment?

- How long would I want treatment to continue if I were unlikely to recover?

- When would comfort-focused care be my preference?

- What gives my life meaning and quality?

Steps to Take

1. Obtain advance directive forms from your healthcare provider or a trusted resource.

2. Choose a healthcare agent you trust to carry out your wishes.

3. Discuss your decisions with your medical provider, especially if you have a chronic or progressive condition.

4. Clearly document your wishes, including preferences about CPR, breathing machines, and artificial nutrition or hydration.

5. Share copies with your healthcare agent, family members, and care team.

Do not store original documents in a location that cannot be accessed in an emergency.

Review and Update Your Plan

Your healthcare wishes may change over time. Review your advance care planning documents periodically, especially if your health status changes. If you update your wishes, complete new forms and share them with everyone involved in your care.

State laws vary. If you move or spend significant time in another state, your documents may need to be reviewed or updated.

Support and Resources

Winner Regional Health encourages open conversations about advanced care planning. Our care team can help answer questions, provide resources, and guide you through the process.

For additional education and planning support, visit LifeCircle at lifecircle.sdaho.org.

If you would like assistance with advance care planning, please contact Winner Regional Health to schedule a conversation with your healthcare provider.

Visit https://lifecircle.sdaho.org/advance-care-planning/ for more helpful resources for your advanced care planning.