Navigating chronic or serious illness can be frustrating and overwhelming for caregivers and patients. Introducing palliative care (as soon as possible after diagnosis) can offer much-needed guidance and support to help improve quality of life. One benefit of palliative care is it promotes advance care planning to help patients and caregivers address their goals of care.
Guest Article by: Gavin Baumgardner, DO, MHA
Guiding Care Today and Tomorrow
Why is this so important? According to research, as few as one in three adults in the United States have completed advance directives. This valuable documentation captures discussions about current and future healthcare decisions, helping to ensure that a patient’s healthcare team stays informed throughout the care journey, including at the end of life. It includes key components like a healthcare power of attorney (HCPOA), which gives caregivers the legal authority to make critical decisions if their loved one cannot.
For those living with complex or serious illness, this holds special weight, because sudden changes in health can lead to a person becoming more seriously ill or unable to communicate their wishes for care, creating confusion and distress. It can be frightening and difficult to make decisions about care in the best of circumstances—in an emergency, it’s even harder.
Palliative care naturally leans into discussions about the best ways to decrease bothersome symptoms, improve quality of life and make choices about care that align with a person’s wishes. This not only helps guide care today, but also at the end of life, because it is a chance to guide patients and their families through what to expect in the future as their illness follows its natural course.
Better Outcomes at the End of Life
As a palliative care provider, I often see the benefits of advance care planning play out in several ways. One study illustrated it well: in a group of advanced cancer patients and their caregivers, documenting end-of-life discussions resulted in lower rates of ventilation, less ICU admissions and earlier hospice enrollment. This also helped caregivers, who reported better quality of life themselves when their loved ones enrolled in hospice and received less aggressive medical care at the end of life.
Caregivers are often entrusted with making sure their loved ones’ wishes are followed throughout their care journey, especially when they are seriously ill or unable to advocate for themselves. The majority of those surveyed (71%) by the Kaiser Family Foundation (KFF) about end-of-life care indicated they would prefer to die at home, with 49% of respondents sharing they consider it “extremely important” their wishes for care are followed and another 36% saying it’s “very important.”
Palliative care and advance care planning are at the heart of making sure that happens. Without advance directives like a living will or HCPOA, it’s more likely for patients to die in a hospital rather than at home, with treatments they did not want or may not have chosen if they had been clear on their options before a crisis arose.
Steps to Take Today
Regardless of where your loved one is at on their healthcare journey, putting advance directives in place is an important step. It’s also not exclusive to palliative care, although palliative care providers are seasoned at helping people navigate advance care planning.
Along with POAs for healthcare, living wills and any other state-specific forms — like Portable Orders for Life-Sustaining Treatment (POLST) or Medical Orders for Life-Sustaining Treatment (MOLST) — can help document care wishes, including any decisions involving artificial nutrition, CPR, blood transfusions and other life-sustaining treatments.
Any healthcare provider should be able to guide patients to the appropriate local resources or help with completing this documentation themselves. You can also ask your provider about national advance care planning programs like Five Wishes, which aid individuals and their families in discussing advance directives and goals of care and documenting their choices.
As we continue to have these important conversations about advance directives, it’s my hope that we will see the number of Americans with documented advance care plans increase. In 2025, I encourage you to have these important conversations with your healthcare providers to support your loved ones in completing advance directives.
Gavin Baumgardner, DO, MHA, is the Vice President and National Medical Director of Palliative Care at Home for Contessa Health, a leading provider of comprehensive care at home. With more than 20 years of experience in the healthcare field, his expertise in geriatric care, inpatient care and hospital medicine guided him to his current role. Dr. Baumgardner previously served as Vice President of Clinical Affairs for OhioHealth Mansfield and Shelby hospitals. He has also contributed to several medical publications and taught as an associate professor of medicine at the Ohio University College of Medicine.
