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Advance Directives: Know Your Choices and Share Your Wishes

If you were struck with a sudden illness or in an accident that prevented you from making your own medical decisions, would it be important to you to have someone to make decisions for you and speak on your behalf? Most people have not planned for this situation. This post will detail some things to consider and put in place, but each state has its own laws, so be sure to review to you research, and verify this information on your state’s Department of Health website.

Learn about Advance Directives

Advance Directives plan for future medical care and is a continual process, and not an isolated event. Advance Care Planning assists you in preparing for a sudden unexpected illness, from which you expect to recover, as well as the dying process, and ultimately death. As tough of a topic that this can be to discuss, advance directives are a gift to you and your family, permitting peace of mind for all by reducing uncertainty, and helping to avoid confusion and conflict over your care. Advance directives apply only when the need arises, and you are unable to make your own health care decisions.

Types of Advance Directives

In most cases (although it can vary by state), you do not need a lawyer for these forms and many do not need to be notarized. Typically the guidelines are that the identified person must be at least 18 years of age; documents are properly signed, witnessed and dated; and documents are available when needed (not in a safety deposit box). You should give a copy to your Health Care Proxy, family, doctor, and keep a copy with you.

The following documents are important to have in place:

Health Care Proxy: this document names someone to make decisions about your medical care any time you are unable to make your own medical decisions, not only at the end of life. One of the strongest reasons for naming a spokesperson is to have someone who can respond flexibly to changes in your medical situation. You do not need to add specific instructions to your Health Care Proxy except regarding artificial nutrition and hydration.

Share your wishes with your health care spokesperson. Discuss your wishes with them often, particularly if your medical condition changes. Your spokesperson will assure that your wishes are carried out based on your expressed and discussed values and beliefs. Discuss things such as:

  • Will you respect my wants, even if you don't agree with them?
  • Will you seek out information about my disease and what to expect as I get sicker?
  • Your desire to be an organ donor.
  • Your wishes for funeral and burial services.

HIPAA Release: A HIPAA release gives your spokesperson access to your medical records and information. This needs to be used with the health care proxy.

Living Will: a living will states your wishes about medical care in the event that you develop an irreversible condition that prevents you from making your own medical decisions. You may add specific instructions such as, “I want maximal pain medications, even if it hastens my death,” “I want to die at home,” etc. If you have appointed a spokesperson, it is a good idea to include a statement such as, “Any questions about how to interpret or when to apply my Living Will are to be decided by my spokesperson.”

Power of Attorney: A power of attorney gives your spokesperson the ability to manage financial affairs, pay bills, sell property, and so on, on your behalf.

We have compiled this checklist as a guideline, but be sure to consult with your doctors, with an attorney, and do your own research to ensure your advance directives are met.

Checklist for Action

  1. Think about what is important and share it with your family
  2. Choose a spokesperson and alternate spokesperson
  3. Discuss wishes with spokesperson, doctor, family, attorney
  4. Discuss wishes regarding artificial nutrition and hydration with spokesperson
  5. Complete Health Care Proxy form
  6. Document on Health Care Proxy that spokesperson knows your wishes regarding artificial nutrition and hydration
  7. Document wishes regarding organ donation on Health Care Proxy, Driver’s license/organ donor card
  8. Complete HIPAA Form
  9. Complete Living Will
  10. Complete Power of Attorney Form
  11. Give copies of Health Care Proxy, HIPAA Release, Living Will and Power of Attorney to spokespersons, family, doctor, attorney
Conversations about advance directives and planning for the future can be difficult, but having this information in place will give peace of mind to you and your loved ones. Be sure to do you research, understand your choices, and communicate your wishes.
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