Guide to Advance Directives
Tools and Tips
What You Should Know About Advance Directives
What medical treatment would you choose if you had a stroke that left you unable to speak and completely dependent upon other people? If you were terminally ill and near death, would you choose to be resuscitated if your heart stopped beating?
While difficult, experts say it’s important to answer these questions, and share your answers with those close to you, so you receive the care you want in such situations—even if you’re unable to communicate them on your own.
For more information on advance directives, visit the American Geriatrics Society’s Health in Aging Foundation’s website: http://www.HealthinAging.org/making-your-wishes-known/
To ensure you receive the care that reflects your choices and values it is important to prepare an “advance directive.” Advance directive is a general term used to describe living wills and medical powers of attorney. Advance directives only covers health decisions. They do not cover financial decisions.
Although advance directive policies are determined primarily at the state level, in 1991,
Congress enacted the Patient Self–Determination Act (PSDA). This act requires that all health care facilities receiving Medicare or Medicaid reimbursements must inform patients of their rights to make choices about the treatment they receive and to prepare advance directives.
Healthcare providers will rely on your advance directive for guidance only when you are no
longer able to make decisions about and tell them what kind of care you want. As long as you and your healthcare provider agree that you are able to make decisions about your treatment yourself, you will be able to do so.
The ideal advance directive includes a “durable power of attorney for healthcare” (DPAHC)
and a “living will.”
- A living will tells your advocate, physicians and other healthcare professionals what kind of medical treatment and care you would and wouldn’t want. Among other things, you may choose to specify in your living will that you always want the best possible “palliative” care—care designed to keep you as comfortable as possible.
- A durable power of attorney for health care (DPAHC) A durable power of attorney for health care (DPAHC) identifies the individual you want to make treatment decisions on your behalf if you’re unable to make these decisions yourself. This individual—known as a “surrogate” or “advocate”—is usually a relative or close friend. Before you prepare a DPAHC, you should make sure he or she is willing to make such decisions on your behalf. You should also specify the type of medical care you do and do not want. In addition, if you want your advocate to be able to refuse care that is needed to keep you alive, you must put this in writing in your DPAHC.
Preparing an advance directive doesn’t have to be complicated. You don’t need a lawyer, but you can choose to have a lawyer help you. Different states have different laws concerning advance directives and you can find free DPHAC and living will forms for your state on the National Hospice and Palliative Care Organization’s website, www.nhpco.org.
These tips can also help you prepare an advance directive:
Talk to your relatives, friends, and healthcare providers Explain your wishes so your family, friends, and providers understand and are prepared. It’s a good idea to make multiple copies of your advance directive and distribute them to your healthcare providers, local hospital, and family members. A copy of your advance directive should be a part of your medical record.
Keep a copy Put another copy of your advance directive in a safe, easy-to-find place. You may also want to put a note in your wallet explaining that you have an advance directive and where it can be found.
Review and revise your advance directive as needed. Over time, you may change your mind about what kinds of treatment you would, and wouldn’t, want. If you complete a new advance directive, it replaces the previous one. An advance directive remains in effect until you change it.
DISCLAIMER: This information is not intended to diagnose health problems or
to take the place of medical advice or care you receive from your physician or
other healthcare provider. Always consult your healthcare provider about your
medications, symptoms, and health problems.
Last updated January 2016