Advance directives allow you to document your personal wishes and goals for medical treatment at end of life. You also pick people who can act for you if you are unable to make decisions, so that your wishes can be carried out the way you want.
They are legal documents which may vary from state to state. Advance directives are not just for people with cancer or people who are dying. Everyone should have them in place so that good decisions can be made in medical emergencies.
You can download advance directives for your state and instructions for filling them out from Caring Connections.
- Medical power of attorney allows another individual to make decisions for someone who is not physically capable of doing so. This may also be known as durable power of attorney for health care, health care agent, or health care proxy.
- Power of attorney gives an individual the right to act on behalf of another person in financial or real estate issues.
- A living will provides information about how a person wants to be treated medically if the person cannot speak for himself or herself. It may also be referred to as a directive to physicians, healthcare declaration, or medical directive. Living wills tell families and health care staff what kind of life-sustaining care the person wishes to have such as cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, or dialysis.
- DNR or Do-Not-Resuscitate orders must be written by a physician, although they can be written at the request of patient or family. A person with a valid DNR will not be given cardiopulmonary resuscitation (CPR) if their heart or breathing stops. DNR orders can be written for hospital care or for patients who are being cared for at home.
Legal requirements for completing and changing advance directives vary according to state law. Your state also defines who can witness them and whether they must be notarized.
Living Wills and medical power-of-attorneys (health care proxy) cannot go into effect until a doctor certifies that you are unable to make your own medical decisions. If your condition improves, your health care proxy can no longer speak for you. Emergency medical technicians cannot honor living wills or health care agents. By law, if they are called, they must stabilize an individual and transport him to a health care facility.
If you or your loved one has a DNR signed by a physician, be sure that it is put where the emergency medical personnel can see it or those caring for the patient at home can find it quickly and easily.
Five Wishes™ is a document produced by Aging with Dignity that lets your family and health care team know how you want to be treated if you are seriously ill and unable to speak for yourself. It is a valid legal advance directive in 40 states. Where it is not yet a legal document, it can be attached to the formal directive.
More than just a legal document, it helps families talk about critical illness and dying and patients understand what their choices for care are.
Five Wishes lets your family and doctors know:
- Which person you want to make health care decisions for you when you can’t make them
- The kind of medical treatment you want and don’t want
- How comfortable you want to be
- How you want people to treat you
- What you want your loved ones to know
Where Can You Go for More Information
The Consumer’s Toolkit for Health Care Advance Planning developed by the American Bar Association has questionnaires to help you think about advance directives like choosing a health care agent, deciding on the care you want, and what you would like your family to know after your death. The Toolkit does not create advance care directives, but helps you plan what is important to you.