Advance Health Care Directive

A medical or health care power of attorney is a type of advance directive in which you name a person to make decisions for you when you are unable to do so.

Advance directives aren’t just for older adults. Unexpected end-of-life situations can happen at any age, so it’s important for all adults to prepare these documents.

In some states this directive may also be called a durable power of attorney for health care or a health care proxy. Choosing a person to act as your health care agent is important. Even if you have other legal documents regarding your care, not all situations can be anticipated and some situations will require someone to make a judgment about your likely care wishes.

End of Life Decisions

End of Life Decisions need to be written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation.

End of Life Decisions can be a separate document or included as a part of your Advance Healthcare Directive (AHCD)

In determining your wishes, think about your values. Consider how important it is to you to be independent and self-sufficient, and identify what circumstances might make you feel like your life is not worth living.

Here are a few basic questions you can ask yourself…

Would you want treatment to extend your life in any situation?
Would you want treatment in all situations?
Would you want treatment only if a cure is possible?
Cardiopulmonary resuscitation (CPR) restarts the heart when it has stopped beating. Would want to be resuscitated by CPR or by a device that delivers an electric shock to stimulate the heart?
Mechanical ventilation takes over your breathing if you’re unable to breathe on your own.
Comfort care (palliative care) includes any number of interventions that may be used to keep you comfortable and manage pain while abiding by your other treatment wishes. This may include being allowed to die at home, getting pain medications, being fed ice chips to soothe mouth dryness, and avoiding invasive tests or treatments.
Organ and tissue donations for transplantation can be specified in your Advance Health Care Directive.
Donating your body for scientific study also can be specified. Contact a local medical school, university or donation program for information on how to register for a planned donation for research.
Do not resuscitate and do not intubate orders

You don’t need to have an advance directive or living will to have do not resuscitate (DNR) and do not intubate (DNI) orders. To establish DNR or DNI orders, tell your doctor about your preferences. He or she will write the orders and put them in your medical record.

Creating Advance Directives

Advance directives need to be in writing.

Depending on where you live, a form may need to be signed by a witness or notarized.

You can ask a lawyer to help you with the process, but it is generally not necessary.
Keep the originals in a safe but easily accessible place.
Give a copy to your doctor.
Give a copy to your health care agent and any alternate agents.
Keep a record of who has your advance directives. Having a clear understanding of your preferences can help your family members avoid conflict and feelings of guilt.

Carry a wallet-sized card that indicates you have advance directives, identifies your health care agent and states where a copy of your directives can be found.

Keep a copy with you when you are traveling. Reviewing and changing advance directives.

A POLST is intended for people who have already been diagnosed with a serious illness. This form does not replace your other directives. Instead, it serves as doctor-ordered instructions — not unlike a prescription — to ensure that, in case of an emergency, you receive the treatment you prefer. Your doctor will fill out the form based on the contents of your advance directives, the discussions you have with your doctor about the likely course of your illness and your treatment preferences.