It’s that time of year – time to write or review your advance directive for health care.
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Highlights
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What IS an advance directive?
An advance directive for health care is a legal document that states your wishes about health care choices. Advance directives can be general, with very few directions about your care. They can also be very detailed and clearly outline the different types of life-sustaining treatments you would accept or refuse in certain situations.
The 1990 Patient Self-Determination Act (PSDA)
The PSDA encourages all people to make choices and decisions now about the types and extent of medical care they want to accept or refuse in the future should they become unable to make those decisions due to illness. Among other dictates, the act requires all health care agencies to recognize the living will and durable power of attorney for health care.
The directive may be as simple as the naming of a proxy or surrogate to make these decisions for you should you be unable to do so. Or, along with the proxy selection, it may include some specific instructions, too. Some types of advance directives are limited to certain situations such as organ or tissue donation, or your wishes not to be resuscitated if your heart or breathing stops.
Regardless of type, no one will be able to control your money or other property based on your advance health care directive. What’s more, you can also change or revoke (take back) these directives at any time.
As you plan for the new year, give some thought to whether you need an advance directive, or review an existing directive to make sure it still meets your needs. There are two common types:
The Living Will
The living will is a formal, legal document setting forth your choices for future health care. It will be used only if you become incapacitated or are unconscious and therefore unable to make decisions yourself. It sets forth the type of medical treatment you would want in these and other situations and under what conditions life-sustaining treatment should be started or stopped.
A living will provides instructions only about conditions that you anticipate could happen and does not cover every situation that might arise in the future, so it may not cover your individual situation when you need it. That’s why a living will should be reexamined every couple of years to be sure it reflects the most current medical advances.
A Durable Power of Attorney for Health Care
Like the living will, this legal document also sets forth your choices for future health care, but you may choose a surrogate or proxy to make health care decisions for you if you become unable to do so. If a situation arises in which your wishes have not been specifically stated, this person will make decisions based on what he or she considers to be in harmony with your wishes.
How to Write an Advance Health Care Directive
Both the living will and the durable power of attorney are formal, legal documents written and signed by the patient. Some states require a specific form but in most states this is optional although the law may require the document to be witnessed and notarized. Because laws differ from state to state, know your rights and your state’s laws pertaining to advance directives.
Here are steps to take as you draft your own health care directive:
- Discuss your decisions and wishes with family members, close friends, your doctor, and/or your attorney. Telling those close to you about your end-of-life decisions will help ensure that your wishes are carried out.
- Understand the meaning of each type of health care directive and the differences between each of them. Then, decide which directive you want.
- Decide what you want your advance directive to say. If possible, be specific about such things as CPR, artificial respiration, medicines to make your heart work, kidney dialysis, artificial feeding (tube or intravenous), and certain surgical procedures.
- If you need help writing an advance directive, you may wish to contact an attorney who knows the laws of your state. However, only you can make the actual decisions about your future care.
- If you opt for a durable power of attorney for health care, weigh carefully whom you want as your health care surrogate or proxy. This is one of the most important decisions you will ever make.
- Have one or more witnesses sign your advance directive. Give a copy of your advance directive to your health care proxy and ask him or her to keep it in a safe place where it can be found quickly if needed.
- Keep a copy of your advance directive in an easy-to-find place so that someone else can locate it quickly if you are in the hospital and need it. Make sure that someone close to you knows where your advance directive is kept. Do not lock it in a safe-deposit box, home safe, or filing cabinet that only you can open. You may also want to give a copy to your attorney.
- Every once in a while, talk to your health care proxy about your advance directive in order to remind him or her of this important responsibility. If your wishes change, be sure to talk this over with your proxy and your doctors.
Click here for in-depth discussion of advance directives.
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