When it comes to being prepared for death, whether unexpected or later in life, one of the most important things that an individual can do for their family is to plan ahead how decisions will be made related to your health. A very important tool that is designed to address these events is known as an Advance Healthcare Directive.
An advance healthcare directive is a legal document that allows a person that you identify, to make decisions for you when you are unable to. They also provide direction to healthcare providers and caregivers related to terminal illness and late stages of life. Advance healthcare or medical directives are also often referred to as a durable power of attorney for healthcare or healthcare proxy.
Most often, close family members are identified to make the decisions (e.g., spouse, children, sibling) and a second individual is also identified in the event the first person is unable or refuses to accept the decision-making.
Placing someone in the position of having to make potentially life changing or ending decisions about you is a very serious matter and careful thought should be made.
Some factors to consider when selecting the individual(s) include:
- Someone you can trust to make rational decisions…even under pressure.
- Someone who understands your wishes and is willing to make a tough decision.
- Someone who is willing to sit down with you to discuss the directive.
- Someone who is not your healthcare provider or part of your healthcare team.
- Someone who meets the legal requirements set forth by your state.
When planning your advanced healthcare directive, the following are topics that should be considered:
- Interventions that can be used to manage pain and keep you comfortable (comfort care).
- If you wish to be tube fed and for how long.
- If you are willing to be treated with dialysis and if so, how long.
- If your heart stops, do you want to be resuscitated.
- If you can’t breathe, do you want to be places on a machine to help you breathe (mechanical ventilation).
- If you die, do you want your body, tissue and/or organs donated.
When you decide who you would like to be responsible for making your healthcare decisions
The laws and procedures related to advance healthcare directives vary by state. Thus, it is important to review your specific state’s laws (some states have pre-formatted documents to ease the process of creating the directive). The American Bar Association and National Hospice and Palliative Care Organization are two good resources for advance healthcare directives.
Once you have completed your directive, it is important to:
- Provide a copy to your healthcare provider and the individuals identified to make decisions.
- Keep an original copy in a safe location.
- Keep a copy of the directive with you when you travel.
If you need to revise your advance healthcare directive, you will need to create a new form and be sure to distribute the new copies to those individuals who should have it. It is very important to ensure that you discuss any revisions with your healthcare provider and be sure they add it to your medical record. Some reasons people may need to change their directive includes changes in marital status (getting married or divorced), changing how you want decisions to be made, or being diagnosed with a disease that alters your life.