Advance directives address 'what ifs' about your health
It's a question that haunts many people who are aging or who have a terminal disease: What will happen if I become unable to voice my own wishes about my healthcare?
Advance directives are legal documents that can help address this concern.
One type of advance directive is a living will. In it, you can give instructions about what life-sustaining measures you want doctors to take if you become terminally ill, permanently unconscious or are otherwise unable to make decisions for yourself.
Durable power of attorney for healthcare
You can also complete a durable power of attorney for healthcare. This type of advance directive allows you to appoint a person who will make medical care decisions for you if you are unable to do that yourself. Here you also can include instructions about any treatment you want or do not want.
Appointing an agent
An important part of ensuring that your advance directive is followed is appointing a person, your agent, who will make healthcare decisions for you based on your wishes. This individual should be familiar with your opinions on life-sustaining or major medical treatments so that he or she can make the decision you would make.
Laws vary by state
Advance directives are generally recognized throughout the country, although according to the National Hospice and Palliative Care Organization (NHPCO), laws governing them vary from state to state. However, even if advance directives aren't officially recognized by the laws in your state, your advance directives can still provide guidance to your loved ones and your doctor if you can no longer speak for yourself.
Creating an advance directive
You can make an advance directive by filling out a form. Make sure you read all instructions carefully to ensure that you include all required information and that your documents are witnessed properly.
You can download advance directive forms for each state free at www.caringinfo.org.
Consult your doctor or an attorney to ensure that you are going through the correct steps to create an advance directive.
Canceling or changing an advance directive
Directives can be canceled or changed by you at any time. You should review your advance directives periodically to be sure they still reflect your wishes.
All changes should be signed and dated. Again, you may wish to consult your doctor or an attorney to be sure the changes comply with your state's laws. If the changes are substantial, you should complete a new document. Notify your agent and healthcare provider in writing of the changes.
What should your directive say?
Writing advance directives requires you to make some difficult decisions. According to the NHPCO, asking these questions can help:
- Are there specific medical treatments you do not want?
- Are there specific medical treatments you do want?
- Would you want to receive treatments such as mechanical ventilation or tube feeding for a time, but have them stopped if there was no improvement in your condition?
- Do want to receive these specific treatments no matter what your medical condition? Would you want to receive them on a trial basis?
- If your heart stopped, under what conditions would you want doctors to use CPR to try to resuscitate you?
Remember, you don't need to give your agent a long list of specific directions. Because situations may occur that you did not anticipate, you need to talk with your agent about your values and your views on quality of life. That will give him or her adequate information to make care decisions for you.
However, if you have specific wishes or preferences, you should detail them in your directive.
If you don't have a directive
If you haven't created any advance directives, healthcare providers generally consult with the family to help make care decisions. The hospital's ethics committee may also be involved. A directive can spare your family members the stress of being forced to make difficult decisions when they are unsure of your wishes.
Once your directive is signed
Copies of your completed directives should be given to your doctor, your agent, your alternate agent, and any close relatives or friends who might be involved in your care. Your local hospital might also be willing to file your directives in case you are admitted in the future.