Aging isn’t the only reason to look into an Advance Healthcare Directive. A medical crisis could leave you too ill to make your own healthcare decisions at any age. Even if you are not sick now, planning for health care in the future is an important step toward making sure you get the medical care you would want, if you are unable to speak for yourself and doctors and family members are making the decisions for you.
What Is Advance Care Planning?
Advance care planning involves considering ahead of time the choices that might need to be made when/if you cannot voice them yourself and documenting your healthcare preferences. These preferences are often put into an advance healthcare directive, a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. This could be the result of disease or severe injury—no matter how old you are. It helps others know what type of medical care you want.
An advance directive also allows you to express your values and desires related to end-of-life care. Your healthcare directive is a living document; one that you can adjust as your situation changes. REMEMBER: An advance healthcare directive is just one document in a complete estate plan.
Advance Care Planning Decisions
Sometimes it can be necessary to make decisions about emergency treatments. Doctors can use several methods to keep you alive. Decisions that might come up at this time relate to:
- CPR (cardiopulmonary resuscitation)
- Ventilator use
- Artificial nutrition (tube feeding) and artificial hydration (IV, or intravenous, fluids)
- Comfort care
Your advance healthcare directive gives you the opportunity to make these difficult decisions for yourself before they are ever necessary. Documenting your choices and sharing them with you family and healthcare professionals is an important step of completing this process.
Getting Started with Advance Care Planning
Although most healthcare directives are straight forward regarding end-of-life decisions, talking to your doctor about your current and future health conditions is highly recommended.
In considering treatment decisions, your personal values are key. Is your main desire to have the most days of life? Or, would your focus be on quality of life, as you see it? What if an illness leaves you paralyzed or in a permanent coma and you need to be on a ventilator? Would you want that? Including these decisions will make the process easier for you and your family.
Keep in mind, your decisions could be different when you are 40 than when you are 80. This “living” healthcare directive can be updated as often as needed to reflect new health, financial, and family considerations.
Directive vs Power of Attorney
Durable power of attorney for health care. A durable power of attorney for health care is a legal document naming a healthcare proxy, someone to make medical decisions for you at times when you are unable to do so. Your proxy, also known as a representative, surrogate, or agent, should be familiar with your values and wishes. This means that he or she will be able to decide when treatment decisions need to be made. A proxy can be chosen in addition to or instead of a living will. Having a healthcare proxy helps you plan for situations that cannot be foreseen, like a serious auto accident.
In the absence of a healthcare directive, the POA will make decisions on your behalf and best reflect your values and wishes.
Healthcare Directives. A healthcare directive expresses your wishes about a single or multiple specific medical issues. A living will usually covers only the specific life-sustaining treatments discussed earlier. You might want to give your healthcare proxy specific instructions about other issues, such as blood transfusion or kidney dialysis. This is especially important if your doctor suggests that, given your health condition, such treatments might be needed in the future.
Medical issues that might arise at the end of life include:
- Do Not Resuscitate orders (DNR)
- Organ and tissue donation
How to Choose Your Healthcare Proxy
If you decide to choose a proxy, think about people you know who share your views and values about life and medical decisions. Your proxy might be a spouse, family member, a friend, your lawyer, or someone in your social or spiritual community. It’s a good idea to also name an alternate proxy. It is especially important to have a detailed living will if you choose not to name a proxy.
You can decide how much authority your proxy has over your medical care—whether he or she is entitled to make a wide range of decisions or only a few specific ones. Of course, check with those you choose as your healthcare proxy and alternate before you name them officially. Make sure they are comfortable with this responsibility. Again, these documents can be updated and amended to reflect new circumstances.
Making Your Healthcare Directives Official
Gallinger Law is ready to help you and your family prepare for when the final day comes. After discussing your life, retirement, and legacy goals, we can recommend the best fitting solutions for you.
Some states require your advance directive to be witnessed; a few require your signature to be notarized. A notary is a person licensed by the state to witness signatures. You might find a notary at your bank, post office, or local library, or call your insurance agent.
What to Do After You Set Up Your Advance Directive
Give copies of your advance directive to your healthcare proxy and alternate proxy(ies). Give your doctor a copy for your medical records. Tell close family members and friends where you keep a copy. If you have to go to the hospital, give staff there a copy to include in your records. Because you might change your advance directive in the future, it’s a good idea to keep track of who receives a copy.
Review your advance care planning decisions from time to time—for example, every 10 years, if not more often. You might want to revise your preferences for care if your situation or your health changes. Or, you might want to make adjustments if you receive a serious diagnosis; if you get married, separated, or divorced; if your spouse dies; or if something happens to your proxy or alternate. If your preferences change, you will want to make sure your doctor, proxy, and family know about them.
Be Prepared
What happens if you have no advance directive or have made no plans and you become unable to speak for yourself? In such cases, the state where you live will assign someone to make medical decisions on your behalf. This will probably be your spouse, your parents if they are available, or your children if they are adults. If you have no family members, the state will choose someone to represent your best interests.
Always remember: an advance directive is only used if you are in danger of dying and need certain emergency or special measures to keep you alive, but you are not able to make those decisions on your own. An advance directive allows you to make your wishes about medical treatment known.
It is difficult to predict the future with certainty. You may never face a medical situation where you are unable to speak for yourself and make your wishes known. But having an advance directive may give you and those close to you some peace of mind.
Todd Gallinger is a California and New York licensed attorney experienced in Islamic Estate Planning. You can reach the Gallinger Law team at (888) 255-9147 or info@gallingerlaw.com.
This article is for information purposes only, and should not be construed as legal advice. For advice specific to your situation, please contact an estate planning professional qualified in the state where you live.