Resources for the Who's Your Agent?® Program
Every person can make a plan
Your personal care plan helps you talk with family and important people about your care goals and preferences, and work in partnership with your health care providers to get good care today and over your lifetime. All tools are free and downloadable and based on Massachusetts law.
Consumers and health care providers use the same step-by-step planning process and tool kits below. Here's how it works-
START with the Step by Step Planning Process
View the short video. Start with a simple conversation to make care choices.
Use the Getting Started and Next Steps Tool Kits
Write down your care choices in MA documents to get good care that's right for you.
Personalize and Update Your Care Plan
Add a wallet card, multi-lingual documents and more to update your plan.
Gather Your Group for a Virtual Presentation
Consumers will make a plan. Care professionals will enhance knowledge & skills.
The Honoring Choices Partners work together to promote equal access to planning tools and standardize planning conversations.
Simple Step Campaign
The Simple Step Campaign brings together health care and community groups to engage adults in simple conversations to complete a Health Care Proxy and Personal Directive (Living Will). Led by the MA Health & Hospital Association with Honoring Choices and a coalition of cross care continuum organizations, Simple Step provides groups with no cost multi-lingual documents and campaign materials. Join us here!
Step-by-Step Health Care Planning Process
The planning process helps you to have simple to serious illness conversations over your lifetime, and make a plan using the Honoring Choices Tool Kits and Ariadne Labs Serious Illness Conversation Guide.
The video below helps you get started!
View the video. Start to make your plan with a simple conversation to Name a Health Care Agent, and complete a Health Care Proxy document.
The process makes it easy to-
- Have Conversations to make care choices;
- Use the accompanying Planning Tools to write down your care choices.
Download the Handout here.
See Translated Videos:
Spanish
Portuguese (Brazil)
Chinese (Traditional)
Getting Started and Next Steps Tool Kits
The tool kits help you write down your care choices and have conversations to put your plan into action.
Getting Started Tool Kit
Start a simple conversation to make your own plan. The tool kit includes conversation guides, documents and fact sheets so you can —
- Name a Health Care Agent
- Appoint your Agent in a MA Health Care Proxy; document available in 15 languages
- Make your own "I Have a Health Care Proxy" Wallet Card
- Talk to important people about your care preferences
- Write down your instructions for care in a Personal Directive (Living Will) document
- Appoint a financial decision-maker in a Durable Power of Attorney; see fact sheet
- Talk with your care professionals about your goals & priorities
- Use the Consumer Conversation Guide 1 to Start a Simple Conversation To Stay Well, to get care that matches your goals and care prefernces.
Next Steps Tool Kit
Build on your conversations from simple to serious illness. The tool kit includes conversations guides and fact sheets so you can —
- Talk with your care professionals using our Consumer Conversation Guides to:
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- Guide 2- Manage Chronic Illness
- Guide 3- Live Well with Serious Illness
- Guide 4- Palliative Care: an extra layer of support
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- Start a MOLST Conversation for individuals with serious illness
- Talk with your health care provider to choose treatment options in a MOLST: Medical Order for Life-Sustaining Treatment; sample medical order and fact sheet
- End of Life Care planning tools; Hospice fact sheet and resources.
Download the Next Steps Tool Kit
- Clinicians and Care Team Members can start early and on-going conversations-
- Care Provider Conversation Guides 2-4; that mirror the Consumer Conversation Guides
- Ariadne Labs Serious Illness Conversation Guide
Adult and Supportive Person Tool Kit
Adults with a range of abilities can chose a supportive person to make a plan, and complete a simplified Personal Directive using both words and pictures. This tool kit can be used by any adult who would like to make plan with the help of a supportive person, including adults who do not have the capacity or ability to complete a Health Care Proxy and adults subject to or under a guardianship.
The adult makes care decisions and chooses a supportive person to help make a plan and assist the adult in getting good care. The 3-step guide makes it easy to-
- Step 1. Get health care information to make care choices
- The supportive person provides health information to the adult in any manner the adult can understand.
- List the ways the supportive person can help the adult in making care choices in a handy checklist.
- Step 2- Write down your care choices and preferences
- The supportive person helps the adult complete a Personal Directive using words and pictures.
- The Personal Directive documents the adult's likes and dislikes and ways the adult wants to be cared for.
- Step 3- Talk with your health care providers to get good care.
- The supportive person helps to communicate the adult's care preferences to their health care providers.
- List the ways the supportive person can assist the adult in getting good care and needed services in a handy checklist.
Personalize and Update Your Plan
Use the tool kits above to start your plan. You can personalize and update your plan using the information and tools below.
- How and when to use the 5 MA planning documents;
- Multi-lingual planning documents;
- "I Have a Health Care Proxy" wallet card;
- Handy conversation guide series;
- FAQs and Informational fact sheets.
5 Massachusetts Care Planning Documents
Here are the planning documents we use in Massachusetts. Download informational fact sheets and forms.
Health Care Proxy
Choose a trusted Health Care Agent to make care decisions. Appoint in a Health Care Proxy.
Personal Directive (Living Will)
Write down what's important to you and instructions for the care you want.
Durable Power of Attorney
Choose a trusted person to make financial decisions for you and pay for the care you need.
Medical Orders for Life-Sustaining Treatment
Seriously ill patients talk with clinicians about their treatment decisions and document choices.
Comfort Care / Do Not Resuscitate Order
Seriously ill patients talk with clinicians about resuscitation and document choices.
Multi-lingual Documents, Wallet Card & Videos
Health Care Proxy
Download Health Care Proxy in 15 languages
English - English
Español - Spanish
Português - Portuguese
Tiếng Việt - Vietnamese
Kreyòl Ayisyen - Haitian Creole
Kiswahili - Swahili
नेपाली - Nepali
简体中文 - Simplified Chinese
Tagalog - Tagalog
Русский - Russian
繁體中文 - Traditional Chinese
عربي - Arabic
ភាសាខ្មែរ - Khmer
Shqip - Albanian
Polish- Polski
Your Voice, Your Choice Videos
Personal Directive
Download Personal Directive in 5 languages
Español -Spanish
Português - Portuguese
Русский -Russian
繁體中文 - Traditional Chinese
Wallet Card
"I Have a Health Care Proxy" wallet card in 4 languages
Español -Spanish
Português - Portuguese
繁體中文 -Traditional Chinese
Accessibility
- Screen reader accessible: Use screen reader and fill-able online documents. Learn more.
Handy Conversation Guides
The Honoring Choices Consumer and Care Provider Conversation Guide Series offers 5 key topics to explore with sample questions to help you talk about your care goals and choices. The guides help you build on your conversations as your choices and health needs change.
The Consumer and Care Provider Guides mirror each other for more meaningful and effective conversations.
Honoring Choices Consumer Conversation Guides
5 Things to Talk About with Your Care Providers
Guide 1: Start a Simple Conversation to Stay Well
Guide 2: Managing Health and Chronic Illness
Honoring Choices Care Provider Conversation Guides
5 Things to Talk About with Your Care Providers
Guide 1: Start a Simple Conversation to Stay Well
Guide 2: Managing Health and Chronic Illness
Serious Illness Conversation Guides: Ariadne Labs and The Conversation Project
The Honoring Choices planning process and conversation guides works seamlessly with these serious illness conversation guides:
- For Health Care Providers: Ariadne Labs Serious Illness Conversation Guide
- For Consumers: What Matters To Me Workbook available in English, Spanish, Chinese; by Ariadne Labs and The Conversation Project.
Information and FAQs
Download Fact Sheets and Frequently Asked Questions
Capacity and Decision-Making
Caregivers
Care Planning: Health Care Planning vs. Advance Care Planning
Comfort Care/Do Not Resuscitate Order (CC/DNR)
Durable Power of Attorney
Guardianship
- What is Guardianship?
- Guardians' Role & Decision-Making Authority
Health Care Agent
Health Care Proxy
Hospice Care
Medical Orders for Life-Sustaining Treatment (MOLST)
- What is a MOLST and CC/DNR?
- Sample MA MOLST form
- EMS and MOLST: Things you can do ahead of an emergency!
Palliative Care
Personal Directive
Serious Illness Care
Supported Decision Making
Terms & Tips to Understand Health Care Planning
Who’s Your Agent? Program
Consumers and Care Provider Webinars
Gather your group; we'll provide an informational consumer presentation, and offer a care provider/staff training to confidently engage adults in simple to serious illness conversations.
Now's the Time! Make Your Own Health Care Plan
For consumer and community groups. We'll provide a fun and information virtual session to help every person start to make their own health care plan using the Getting Started Tool Kit. The tool kit includes a MA Health Care Proxy to choose a Heath Care Agent, a Personal Directive (Living Will) to give instructions about your care, and a handy conversation guide to start a planning conversation with your care providers. Learn more.
Engage Adults in Conversations from Simple to Serious Illness
For health care professionals & staff. Choose one or both of the virtual sessions:
- Become a Certified Health Care Planning Ambassador, using the Honoring Choices Getting Started and Next Steps Tool Kit
- Engage Adults in Seamless Conversations from Simple to Serious Illness, using Honoring Choices Tool Kits and introducing Ariadne Lab's Serious Illness Conversation Guide. Learn more.
Honoring Choices Partners: Working Together to Standardize Care Planning and Improve Health Outcomes
Simple Step: A Cross Continuum Care Planning Campaign
The MA Health and Hospital Association and a coalition of leading organizations across the care continuum, have come together to promote long term care planning starting by taking a simple step.
The Simple Step campaign helps patients/ consumers start a simple planning conversation to designate a Health Care Agent and complete a Health Care Proxy document
The coalition is highlighting three key steps for community members:
- Choose someone you trust to be your designated Health Care Agent, and have a simple conversation about how you want to be cared if you get sick and can make care decisions yourself;
- Complete a Health Care Proxy form to appoint your Health Care Agent– you can do it all yourself! The Honoring Choices MA Health Care Proxy is free, downloadable and available in 15 languages,
- Talk with your with your health care team about the care that’s right for you and place your Health Care Proxy in your medical record.
Resources:
- See the partner toolkit and patient resources here.
- Messaging you can adapt and Simple Step graphics
- Download the free Honoring Choices Health Care Proxy, available in 15 languages,
- View a short video- “Complete Your Own Honoring Choices Health Care Proxy”
Come Join us! All state, health care and community organizations across the care continuum are very welcome. We'll provide the process and tools to easily embed simple conversations into your everyday work.
Helpful Webpages
Who's Your Agent? for Care Providers
Our Who's Your Agent? Program for Care Providers and Professionals is a one-stop overview of our structured approach to health care planning. It has everything you need to confidently engage adults in conversations from simple to serious illness, and make a care plan for the best possible care. Read about the Program for Care Providers.
Serious Illness Care
Learn about serious illness care, how to have planning conversations, and consider a MOLST or CC/DNR form. NEW: the POLST Program coming soon. Read more about Serious Illness Care.
Palliative Care
Palliative Care helps people with serious illness have an extra layer of support to relive the pain, symptoms and stress of serious illness. Helps families too. Read more about Palliative Care.
Get Help In Your Community
Meet the Community Partners in 7 regions of the state. They can help you make a personal plan and connect you to care in your community. Find a Partner in your community.
New England Planning Documents
Download state-specific documents from Maine, New Hampshire, Vermont, Rhode Island and Connecticut. Read more about New England documents.
Lifetime Health Care Planning Roadmap
See how the health care planning works at every phase of health- from promoting everyday wellness, to managing health needs and chronic illness, and living well with serious illness. Read more about the Roadmap.