Coronavirus Update: Ethics Considerations, Guidance and Resources.
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COVID-19 Community Resources

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Advance Care Planning During COVID-19

As we practice social distancing to prevent the spread of coronavirus, staying connected and having conversations with loved ones about what matters most is of equal importance. Take some time to share your hopes and fears for the future with those closest to you. Review your advance directive if you have one to make sure it represents your preferences and priorities. If you’ve never completed an advance directive, now is the perfect time to:

  • Name the individual(s) who know you best and could speak on your behalf if you become ill and cannot speak for yourself.
  • Share details about your goals and values so that your family, friends and the health care team can provide the best care possible for you.
  • Give copies of your document to your loved ones, doctor, hospital, and the Vermont Advance Directive Registry.

Frequently Asked Questions

Who can I contact for advance care planning support in my area?

The following individuals and organizations (sorted by county) are available to provide advance care planning support remotely by email, phone, or video call:

CountyOrganizationNameTitleEmailPhoneAdditional Considerations
Addison CountyEnd of Life ServicesLaurie BordenProgram Director(802) 388-4111Phones are staffed from 12pm-2pm, M-F, for questions, information requests, or to schedule a Zoom appointment for one-on-one support.
Chittenden CountyBAYADANick ParrishPsychosocial Manager(802) 448-1610
Chittenden CountyUVMMC Office of Community Health ImprovementCommunity Health Team(802) 847-1601Support is available for patients of Chittenden County UVM Health Network providers. Please call the number listed to verify whether your provider is part of the network.
Chittenden CountyUVM Health Network Home Health & HospiceHolly ThompsonVolunteer Coordinator, Who's Your Person... What's Your Plan?(802) 734-5531Email is the preferred mode of contact.
Orleans CountyNorth Country HospitalNeely Bryant, MSWInpatient Case Management Department(802) 334-3261
Washington CountyCentral Vermont Home Health & HospiceJim Budis, RNHospice & Palliative Care Manager(802) 224-2240
Washington CountyCentral Vermont Medical CenterElaine Hafter, MSWCare Coordinator, Palliative and Spiritual Care Department(802) 371-5375Voicemail will be checked between 8am-4:30pm, M-F. Also available by pager at (802) 452-7949 during this timeframe.
Windham CountyBrattleboro Area HospiceDon FreemanTaking Steps Brattleboro Advance Care Planning Program Coordinator(802) 257-0775, ext 101

Having difficulty viewing this table? Click here.

What if I don’t have anyone that I can name as my health care agent?

At this time of increased social isolation, we understand that it may be challenging for some to identify an appropriate individual to serve as their health care agent, especially in the absence of close family and friends. While someone may not come to mind immediately, keep in mind that your agent doesn’t have to be a family member. According to Vermont law, anyone 18 years of age or older can serve as your agent, with the following exceptions:

“The principal’s health care provider may not be the principal’s agent. Unless related to the principal by blood, marriage, civil union, or adoption, an agent may not be an owner, operator, employee, agent, or contractor of a residential care facility, a health care facility, or a correctional facility in which the principal resides at the time of execution of an advance directive.”

This leaves ample room for a creative approach. We encourage you to think outside the box for someone trustworthy that you could communicate your wishes to and who is willing and able to communicate your wishes to the health care team in the event that you are unable to speak for yourself. It could be a friend, more distant relative, neighbor, or someone from your place of worship.

Even if you may not have someone you wish to name as your health care agent, it is still important to share what is important to you in terms of any future health care needs. If your doctor or the medical team can’t speak to you directly, they will still want to know about your health care priorities and preferences.  Use the short form advance directive, draw a line through the section(s) in Part 1 for appointing a health care agent so it is clear that you did not forget to fill this out but have intentionally left it blank, and complete sections 2 – 5 of the form. You can also attach any additional information that you want health care providers to know. Just be sure that you write your name, date of birth, and the date you are completing the document at the top of any additional pages so it is clear that these pages are to be included with the entire signed and witnessed document. It’s also a good idea to make note on the form itself to “see attached pages” to direct the reader of the document to look for them.

How do I collect witness signatures while social distancing measures are in place?
Vermont Ethics Network is working with policy makers and a number of interested stakeholders on legislation to allow remote witnessing and explaining (if applicable) of advance directives during the COVID-19 Emergency. House bill H.950 is currently making its way through the legislative process. While this happens, we offer the following recommendations for completing an advance directive during this time of social distancing:

 

  1. Talk to your family and friends about what matters most to you and ask someone you trust to be your health care agent.
  2. Choose the form that works best for you and write down your health care goals and priorities.
  3. Identify 2 adults willing to serve as remote witnesses. Please note that witnesses cannot be your agent, spouse, parents, siblings, adult children or grandchildren. For remote witnessing, they must be someone you know. Your health care provider may serve as a witness.
  4. Have your witnesses be on the phone or a video chat and tell them “by being my remote witness you are attesting to the fact that I, the principal, seemed to understand the nature and effect of the advance directive and was free from duress or undue influence at the time of signing”.
  5. Sign and date your document.
  6. Write each remote witness’ name, phone number, relationship to you (i.e. friend, neighbor, work colleague, etc.), and the date on the document.
  7. In the witness signature line, write “verbal witness per COVID-19” if witnessed via telephone discussion, or write “video witness per COVID-19” if witnessed via video conferencing.
We will post information on the VEN website and in upcoming newsletters/announcements if House bill H.950 is passed into law. In the meantime, the steps described above represent the best way to document your wishes during the COVID-19 state of emergency so that you can share them with your health care providers, health care agent and those closest to you. Presently, documents completed during this time do not meet with the letter of the law, but they still carry moral weight and will be considered if a situation arises where you cannot make health care decisions for yourself. Health care agents and surrogates are obligated to make decisions based on what they know is important to you and what they believe you would say if you were able. Information you provide in your document will help them to make care and treatment decisions that align with your goals and preferences. Health care providers and hospitals have autonomy-based obligations to honor preferences you expressed at a time of capacity to the best of their ability.

 

If you create a document using remote witnesses, you should be prepared to complete a replacement advance directive with in-person witnesses as soon as it’s safe to do so.
Where should I send my advance directive once completed?

We recommend that you give copies of your document to your loved ones, doctor, hospital where you are most likely to receive care, and the Vermont Advance Directive Registry. Instructions for how to register your document with the Registry are available here. We have also been in recent communication with a number of hospitals in the state to obtain mailing instructions for completed advance directives. This information is available below and will be updated as additional listings are received:

Sending Completed Advance Directives to Your Local Hospital

Hospital NameDepartmentMailing AddressAttention:Fax (if applicable)Email (if applicable)
Brattleboro Memorial HospitalHealth Information Department17 Belmont Ave, Brattleboro, VT 05301Jon O'Brien
Central Vermont Medical CenterMedical RecordsPO Box 547, Barre, VT 05641(802) 371-5351
Mt. Ascutney Hospital and Health CenterHealth Information289 County Rd, Windsor, VT 05089(802) 674-7152 or
North Country HospitalHealth Information Management (HIM)189 Prouty Drive, Newport, VT 05855
The University of Vermont Medical CenterMedical Records111 Colchester Ave, Burlington, VT 05401(802) 847-5531

COVID Advance Care Planning Tools & Resources

Being Prepared in the Time of COVID-19

A guide with three important things each of us can do, right now, to be prepared.

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TalkVT Patient Prep Guide

How to talk with your clinician about the future.

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Proactive Care Planning for COVID-19: a Guide for High Risk Adults (Respecting Choices)

A guide to aid high risk adults in planning for future healthcare choices and identifying treatment preferences before a medical crisis.

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Role of the Health Care Agent for COVID-19 (Respecting Choices)

A guide to the responsibilities of a health care agent, including determining what your loved one would want if they became ill with the COVID infection.

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COVID-19 Shared Decision-Making Tool (NHPCO)

A tool for proactive informed decision-making to ensure seriously ill individuals can make their wishes known and access care concordant with their preferences as available.

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Making a Medical Plan During COVID-19 (PREPARE For Your Care)

Tip sheet to assist in planning ahead in the event you become ill and to make your care wishes known.

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End-Of-Life Wishes In A Pandemic (VPR)

An episode of VPR's "Brave Little State" exploring how advance directives are affecting treatment and outcomes for COVID-19 patients in Vermont.

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General Information

Centers for Disease Control and Prevention (CDC): 2019 Novel Coronavirus

Information from the CDC, including how to protect yourself, symptoms, guidance for travel, and more.

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World Health Organization (WHO): 2019 Novel Coronavirus

Information from the WHO on what the virus is, how to protect yourself, # of global cases, travel advice, and more.

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COVID-19 Resources for Older Adults, Family Caregivers and Health Care Providers (John A. Hartford Foundation)

A collection of resources and information on what older adults and their caregivers should know.

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COVID-19: Medical Communication Access for Deaf and Hard of Hearing (National Association of the Deaf)

A guide to help deaf and hard of hearing patients prepare for a hospital visit during the COVID-19 pandemic.

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Plain Language Information on Coronavirus (Green Mountain Self-Advocates)

COVID-19 information by and for people with intellectual and developmental disabilities.

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Plain Language Tips for Working with Support Staff During COVID-19 (Green Mountain Self-Advocates)

Tips to help people with intellectual and developmental disabilities deal with the changes associated with Coronavirus.

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Responding to COVID-19: A Science-Based Approach (American Public Health Association & National Academy of Medicine)

A webinar series exploring the scientific basis for guidance issued by government, health and public health organizations, as well as answers to commonly asked questions.

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Empowering and Protecting Your Family During the COVID-19 Pandemic

Dr. David Price of Weill Cornell Medical Center in New York City shares information on empowering and protecting families during the COVID-19 pandemic.

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Ritual and Grief in the Time of COVID-19 - Part 1 (The Conversation Project)

The first of a two-part blog series that discusses the issue of preserving rituals and honoring grief in the unprecedented time of COVID-19.

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Ritual and Grief in the Time of COVID-19 - Part 2 (The Conversation Project)

The second of a two-part blog series that discusses the issue of preserving rituals and honoring grief in the unprecedented time of COVID-19.

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Vermont Resources

Vermont Department of Health: 2019 Novel Coronavirus

Information for Vermonters, including what to do if you have symptoms, when to call, testing activity in VT, and more.

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The University of Vermont Health Network: Coronavirus

Information from the UVM Health Network on what to do if you feel sick, how to protect yourself, visitor restrictions, cases at UVMHN facilities, and more.

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Vermont Association of Hospitals & Health Systems: Coronavirus Facts

Answers to common Coronavirus questions for Vermonters.

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Hospice and Palliative Care Services During COVID-19

Hospice and palliative care agencies across the state are continuing to offer services during the COVID-19 pandemic. Below are overviews by agency of the services each are delivering (we will continue to add more as they become available):