What I Need To Know About Advance Directives

There may come a time in your life when you will be unable to make your own decisions regarding your medical care. An Advance Directive is your life on your terms. Whether you’re 18 or 80, documenting your health care wishes today means your family won’t have to make those heart-wrenching decisions later on when you are unable to make them for yourself.

WHAT IS AN ADVANCE DIRECTIVE?

An Advance Directive   is generally a written statement that you complete in advance of such time that you cannot make your own decisions, such as during a serous illness or severe traumatic event.   Your Advance Directive will outline how you want medical decisions to be made in the event you cannot make them yourself. If you cannot make treatment decisions for yourself, the physician will ask your closest available relative or friend to decide what is best for you. That might be a good thing, but there may be times when that person doesn’t necessarily share your same value system. Or the folks at your bedside may disagree on what decisions have to be made. That is why it is so important for YOU to specify in advance exactly what YOU want to happen in the event that YOU cannot speak for yourself. You have voice but sometimes you need help using it!

There are several types of Advance Directives that you can use to speak for you, telling the health care team what you want and whom you want to speak for you. The two most important forms of an Advance Directive are:

  1. A Living Will; and
  2. A Durable Power of Attorney for Health Care

WHAT IS A LIVING WILL?

A Living Will states the kind of medical care you want or do not want, if you lose your voice and become unable to make your own decisions. It is called a Living Will because it takes effect while you are still living. The Living Will is a document that is limited to the withholding or withdrawal of life-sustaining procedures and/or treatment in the event of a terminal condition where there is no hope for your physical recovery. If you write a living will, give a copy to your personal physician, your closest next of kin and perhaps, your closest friend. It is only good if your health care team has access to it

WHAT IS A DURABLE POWER OF ATTORNEY FOR HEALTH CARE?

A Durable Power of Attorney for Health Care is a document that gives authority to make medical decisions regarding your health care to a person that you designate for such purpose. Again, this designee may be a family member or close friend. This Durable Power of Attorney is not to be confused with a legal power of attorney. This power is solely for the making of health care decisions and only takes effect when you cannot speak for yourself. This Durable Power of Attorney can be specific to a particular treatment or medical condition, or it can be very broad in scope. If you write a Durable Power of Attorney for Health Care, give a copy to your personal physician, closest family member and/or close friend. It is only good if your health care team has access to it.

WHO DECIDES ABOUT MY TREATMENT?

Your physician will give you information and advice about treatment choices. You have the right to choose. You can say ” Yes ” to treatment you want and ” No ” to any treatment you don’t want- even if the treatment might keep you alive longer. You have a voice… use it!

DO I KNOW WHAT I WANT?

Your physician must tell you about your medical condition and treatment options. Many treatments have side effects, and your physician must offer you information about what serious effects can occur as a result of a particular treatment. Oftentimes, there are alternative treatments. Ask your doctor about these.   Your doctor can’t tell you which treatment to choose, but they should be supportive of whatever you decide is in your best interest.   If your physician is unwilling to discuss alternatives with you, that could be your cue to find another doctor who will.

HOW DOES THE PERSON NAMED IN MY ADVANCE DIRECTIVE KNOW WHAT I WANT?

Communication at every stage of life is so important and no less important when it comes to Advance Directives. Families should be having these kinds of conversations all the time, well in advance of any crisis situation. Talk to your loved ones. Know what kind of care they desire in the event that they cannot speak for themselves. Let them know the kind of care you want.

Consider the following:

  • If you have a Durable Power of Attorney, give a copy of the original to your ” agent ” or ” proxy ” or ” advocate “. This designated person ( designee) is that person whom you have authorized to make your medical decisions when you no longer have a voice.
  • Ask your physician to make your Advance Directive part of your permanent medical record so it will be accessible when and if there comes a time when you no longer have a voice.
  • Keep a second copy of your Advance Directive is a safe place and where it can be found easily, if it is needed.
  • GIve a copy of your Advance Directive to your designee.
  • Keep a small card in your purse or wallet that states that you have an Advance Directive and where it is located.   Also include the name of your designee and his/her contact information.

HOW OLD MUST YOU BE TO FILL OUT AN ADVANCE DIRECTIVE?

In the United States, you must be at least 18 years old and of sound mind to make your own health care decisions. The exceptions to this are if you are pregnant;   if you are in the military;   or if you are a legally emancipated minor.

WHOM CAN I NAME TO MAKE MEDICAL TREATMENT DECISIONS FOR ME WHEN I DON’T HAVE A VOICE?

You can choose an adult relative or friend you trust to be your designee and to speak for you when you’re too sick to make your own decisions. There are a variety of Durable Power of Attorney and Living Will forms available from stationery stores, internet sites, lawyer offices;   or you can write your own wishes on a piece of paper and have it notarized. If necessary, your physician and family can use what you write to help make decisions about your treatment when you no longer have a voice.

DO I HAVE TO EXECUTE AN ADVANCE DIRECTIVE?

No. This is entirely up to you but if you want to have any say in the care you receive when you might be unable to find your voice, it is highly recommended that you have one. It might sound complicated to execute, but not having one during a medical crisis can be even more complicated!

WILL I BE TREATED IF I DON’T EXECUTE AN ADVANCE DIRECTIVE?

Absolutely. We just want you to know that if you become too ill to make decisions for yourself, someone else is going to make them… and they may not be the decisions you would have wanted. With an Advance Directive , you can instruct others about your wishes before losing your voice and being unable to do so.

CAN I CHANGE MY MIND AFTER WRITING AN ADVANCE DIRECTIVE?

Yes. You may change your mind or cancel these documents at any time as long as you are competent and can communicate your wishes to your physician, your family and other members of your health care team.

If you have an Advance Directive, be sure to bring a copy of it with you any time you are being admitted to the hospital or other health care facility so it can be kept with your medical records. Remember that your family may not always be at your bedside when critical and life saving decisions might have to be made at times when you might not have a voice

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