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research studies looking at what kind of advanced care planning is really most useful and when we look back and we asked what if clinicians find most helpful advanced care planning documents are part of that but they really are not the most essential piece what is more essential as the conversation actually and the reason is that if you think about it when youre healthy and you have a conversation youre not really sure what medical situation youre going to encounter down the road you dont know if it would be a heart attack or a car accident or a stroke or whatever it may be and so talking about the specific medical interventions that you want to have I want this to or I dont want that or this is where Id like to be cared for is really challenging because those conversations are out of context and its true you may not want a tube in this situation but maybe in this situation you would and so whats often more useful than writing those specific choices down in a document is having
