An Introduction to Advance Directives

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Couple of seniors reviewing advanced directive at home in the living room
Published:  April 16, 2023

When someone reaches the end of their life, illness or aging may make it difficult to communicate with family and healthcare providers. For this reason, it is essential to have an advance directive and a medical power of attorney signed in advance, so your loved ones know what your wishes are. Advance directives communicate medical treatment desires for you, preventing your family from having to make difficult decisions on your behalf. The term advance directive is also at times referred to as a living will as it varies from state to state.

Having an advance directive and medical power of attorney ensures that you remain in control of your medical treatment regardless of circumstances, foreseen or not. It also relieves the burden on loved ones as they will know exactly what treatment(s) you want or don’t want, avoiding the worry that your decisions are not being followed.

An Overview of Advance Directives

An advance directive includes the end-of-life information you want your family and healthcare providers to know about your healthcare decisions if you become unable to communicate those choices. When creating your first advance directive, you can do the following:

  • Ask your healthcare provider about all the end-of-life care alternatives available to you.
  • Spend time thinking about which care alternative works best for you.
  • Share your advanced directive with your doctors and family members.

Within the advance directive, you can include instructions for a wide variety of treatments and procedures. Some of the things that you can include instructions on are:

  • If you want healthcare providers to use a breathing machine.
  • If you want your organs to be donated.
  • If you want to be resuscitated if your heartbeat stops.

It’s important to discuss a wide variety of procedures within the advance directive. However, even if the document is extremely thorough, there’s still a chance that something unexpected will happen. Because of that, it’s a good idea to complete a durable medical power of attorney form. The durable medical power of attorney is different from a durable power of attorney for property and specifically lets you name an agent or healthcare proxy. This person will be allowed to make healthcare decisions for any treatments that you have not included in your advance directive if you are unable to make treatment decisions yourself.

This healthcare proxy should be someone you trust to make decisions for you, in the event you are unable to do so. This can be any person you choose, including a family member or a close friend. This person will serve as your advocate if you are unable to make healthcare decisions for yourself.

Who Should Create an Advance Directive?

Everyone should create an advance directive but it’s especially important for patients with progressive neurodegenerative diseases like dementia or Alzheimer’s disease to create an advance directive. Patients with these diseases should create their advance directive soon after receiving the diagnosis. Additionally, copies of the advance directive should be provided to family members, those people who are named as proxies or agents, and your medical providers, along with discussions about what is contained within the advance directive. This will ensure they understand everything in the document, and you will be able to answer any of their questions about your treatment preferences.

If you have been diagnosed with a terminal illness, it is important to create an advance directive that’s tailored to your illness. Before you begin writing the advance directive, you can talk to your healthcare providers about the treatments you will most likely be given. As the disease progresses, you may begin thinking more about Do-Not-Resuscitate orders and mechanical ventilation. Your healthcare provider will help you understand what these orders mean and help you decide what will ultimately be best for your health and comfort.

Creating your Advance Directive

Each state has different requirements for advance directives. Some states require advance directives to be notarized, while others require a signature from witnesses. Some states ask for both things. The National Hospice and Palliative Care Organization website is one of many resources that can help you find information and state-specific forms, as well as your local state health and human services website.

While creating your advance directive, you can ask your healthcare provider for help with any specific medical terms. Also, you can spend some time discussing your options with family members and friends before deciding what to include. If you are unsure about any legal matters, you can also have an attorney review it as well. Once the forms are complete you should do the following:

  • Put the original forms in a safe place.
  • Give a copy to your healthcare provider and healthcare proxy.
  • Gives copies to your loved ones.
  • Put a card in your wallet that indicates you have an advanced directive and where the document can be found. Be sure to always carry this card.
  • Talk to friends and family members about what is included in your advance directive.

Sometimes, you may need to make a change to your advance directive after it’s been completed. A new diagnosis, change in marital status, and change in healthcare wishes/desires are some of the reasons this document might need to be changed. Each state has specific requirements for changing an advance directive. If you have any questions about your state’s requirements, contact an attorney working in your state. If a new advance directive is created, all copies of the previous document will need to be replaced with the new version.

The Importance of Advance Directives

Although there is no requirement that you must complete an advance directive, they are very important documents for all patients especially those with a terminal illness. They are also important tools for your loved ones. Your advance directive will be able to speak for you in the event you are no longer able to speak for yourself and it will ensure that your healthcare desires are met.

All content on this website is intended for general informational purposes only and should not be construed as legal advice. Before taking any action based on this website or if you have questions regarding the content, you should seek professional advice and consult with your attorney.

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