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April 25, 2019

Creating an Advance Directive: 3 Things to Consider

You’re healthy, active and independent. As a result, you might not give much thought to your end-of-life wishes. After all, you’re healthy, what’s there to worry about?

But consider this: Planning ahead can help you get the medical care you want and relieve the burden of decision-making from family or friends.

An advance directive can help you do just that. Here, we’ll look at what you need to know about these documents.

What is an Advance Directive?

If you are unable to make decisions for yourself — if you’re severely injured or ill — someone will have to make them for you. An advance directive ensures your wishes for medical care are implemented. The wishes you state within them are legally and ethically binding. That means the person you choose as a stand-in decision maker as well as doctors and other healthcare professionals must carry out your wishes.

Advance directives come in two forms: living wills and durable power of attorney for health care, or healthcare power of attorney. A living will outlines what medical care you would or would not like to receive in the event you are terminally ill or unable to make decisions on your own. A durable power of attorney for health care gives you the opportunity to designate someone to make medical decisions for you in the event you’re unable to make decisions for yourself.

If you choose to have a stand-in decision maker, be sure to discuss the types of treatment you would or would not like to receive. Normally, family members are a person’s stand-in decision maker; however, if you have no family nearby, you can make your physician or lawyer a decision maker.

What Happens if I Don't Have an Advance Directive?

Just over one third of Americans have an advance directive in place. If you don't have an advance directive and you become seriously ill or injured, the state will assign someone to make decisions on your behalf. This person will likely be your spouse, children or a sibling. If you have no family available, the state will assign someone to represent your best interests, usually your attending physician or the hospital's chief medical officer. 

What to Consider when Creating an Advance Directive

Be Specific: Often, advance directives fail to be specific when expressing the type of care a person does or does not want and instead state the person does not want any “heroic measures” taken. If you can, be specific about what kinds of treatments you do not wish to receive. These treatments can be things like CPR, the use of a ventilator, tube feeds, intravenous fluids or comfort care.

Communicate: It goes without saying that you should communicate your desires to your decision maker. This is especially important if you change your mind on a treatment or procedure. You also should take time to regularly talk about your medical care decisions with your doctor or other healthcare provider. Ask your provider about common situations that develop with your illness or condition, treatment options and express your wishes. Make sure any updates to your advance directive have been witnessed and signed by a notary as well.

Distribute: Once you’ve created your advance directive, give copies to your decision maker, an alternate decision maker (if necessary) and your doctor. Make sure your friends and family know where you keep a copy.  Alternatively, you can put information on where your advance directive is located on your refrigerator or in your wallet or purse in case of emergency. You can print out an advance directive card for your wallet here

Though you’re healthy now and may never have to face a medical situation where you are unable to advocate for yourself, having an advance directive in place can give you and those you love peace of mind.

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