It’s never easy to think about one’s final days. Fear, anxiety; and denial are just some of the all-too-human emotions that prevent people from taking care of themselves and expressing their wishes at the end of life. Whether you are the victim in an accident or are diagnosed with a serious illness, planning now for your future health care is one of the most important acts you will ever do for yourself and for your loved ones.
Generally, an advance directive is a written statement, which you complete in advance of serious illness, about how you want medical decisions made. While some people may feel that filling out an advance directive means that they have given up hope and are refusing treatment, the truth is that these documents are asking that you be treated the way you want to be treated. The two most common forms of advance directives are living wills and durable powers of attorney for health care.
An advance directive allows you to state your choices for health care or to name someone to make those choices for you if you become unable to make decisions about your medical treatment. In short, an advance directive can enable you to make decisions about your future medical treatment. You can say "yes" to treatment you want or say "no" to treatment you don't want.
No. There is no requirement for anyone to write an advance directive. The decision to write one or not to write one is entirely up to you.
In the event that you become sick and cannot speak for yourself, decisions regarding your health care will be made by someone else, usually a family member. All too often, family members -- spouses, parents, siblings, and adult children -- do not know the wishes of their loved ones regarding treatment and medical decisions during a time of crisis. This creates a situation where your wishes may not be followed since they are unknown.
Don’t leave your health care to chance. Take a few moments to fill out your advance directives to ensure that it is your voice that will be heard during critical decision making times.
The law on honoring an advance directive from another state is unclear. Because an advance directive tells your wishes regarding medical care, it may be honored wherever you are, if it is made known. But if you spend a great deal of time in more than one state, you should consider having your advance directive meet the laws of both states and be on record in both localities.
A living will is a written document in which you state in writing your preferences for medical treatment at the end of life, should you be unable to speak for yourself. It tells the doctors and medical professionals what your wishes are regarding critical issues, such as using life-prolonging drugs and technology; The living will gives you the right to accept or refuse life-prolonging treatment at the end of life. Your wishes are protected by both federal and state laws.
Most states have their own living will forms, each somewhat different. It may also be possible to complete and sign a preprinted living will form available in your own community, draw up your own form, or simply write a statement of your preferences for treatment. You may also wish to speak to an attorney or your physician to be certain you have completed the living will in a way that your wishes will be understood and followed.
Also called a health care proxy, appointment of health care agent, or durable power of attorney for health care,this document lets you appoint someone you trust to be your advocate and make decisions for you regarding your medical treatment and other health and personal care issues. It is effective only if you are unable to make your own health care decisions. Among those you may choose to serve as your agent are family members and friends.
The health care power of attorney is not the same thing as a durable power of attorney for financial affairs. The durable power of attorney document gives your loved one authority over your financial matters, while the health care power of attorney relates solely to your medical needs.
To complete your advance directives, you do not need a lawyer. However, you may wish to consult with a lawyer to check your own state requirements to find out if your documents will need to be witnessed or notarized.
By appointing a health care power of attorney, you are giving your loved ones a tremendous gift. You are giving them the peace of mind to be able to follow your wishes and to help you during this difficult time.
In some states, laws may make it better to have one or the other. It may also be possible to have both, or to combine them into a single document that describes treatment choices in a variety of situations (ask your doctor about these) and names someone (called your "agent" or "proxy") to make decisions for yourself.
Yes. You may change or cancel these documents at any time in accordance with state law. Any change or cancellation should be written, signed, and dated in accordance with state law, and copies should be given to your doctor or to others to whom you may have given copies of the original. In addition, some states allow you to change an advance directive by oral statement.
If you wish to cancel an advance directive while you are in a nursing facility, you should notify your doctor, your family, and others who may need to know.
Even without a change in writing, your wishes stated in person directly to your doctor generally carry more weight than a living will or durable power of attorney, as long as you can decide for yourself and can communicate your wishes. But be sure to state your wishes clearly and be sure that they are understood.
Yes. The living will and the health care power of attorney go hand-in-hand to ensure that your wishes are followed. During your time of crisis, you will need your health care power of attorney agent to speak for you when you can’t speak for yourself, and your living will to reflect your wishes in a written, documented form.
Once you have completed your advance directives, put them away in a safe place, like a safety deposit box or in a desk. Make sure that someone, such as your lawyer or family member, knows that you have an advance directive and knows where it is located. You should also consider the following:
Doctors and other health care providers are legally obligated to follow advance care directives because they contain your decisions about medical treatments. However, some do not. If you find they are not willing to support your choices, you may consider making changes before a conflict arises.
Under federal law, when you enter a Medicare or Medicaid nursing facility or hospital, receive facility health or hospice care from a Medicare - or Medicaid-certified HMO, you will be asked whether you have an advance directive. If you have one, the facility will request that you provide a copy to be placed on record at the facility.
Equally important, sit down with the person you have chosen as your health care agent and talk about your plans and wishes for end-of-life care. Give your agent a copy of the completed documents, and open the lines of communication between you and your health care agent regarding any issues and concerns that may arise from the documents.
Completing advance directives is just the first step in an ongoing process that highlights communication between you, your health care agent, and the medical professionals responsible for your care.
You can obtain advance directives from a number of sources, including your doctor, local hospital, or long-term care facility.
