Do you know what will happen if you are suddenly incapacitated and cannot make decisions for yourself? While it’s human nature to adhere to the “that won’t happen to me” mindset, the reality is that no one knows what the future holds. That’s why every adult needs an advance directive to ensure their wishes concerning medical treatment are carried out if they can’t speak for themselves. Here are the basics of advance directives that everyone needs to know.
What is an advance directive?
Simply put, an advance directive is a legal document that dictates how medical decisions will be made on your behalf if you cannot make them yourself. Since the passage of the 1990 Patient Self-Determination Act, when a patient is admitted, healthcare institutions must provide information about advance healthcare directives, must ask if a patient has one, must recognize and honor the advance directive, and must not discriminate on the basis of whether a patient has one or not.
Different types of advance directives
The term “advance directive” is actually an umbrella term for different types of documents. According to the cancer.org article, “Types of Advance Directives,” these are:
The living will, a legal document defining how you want medical care to proceed if you cannot make decisions at the time care is needed. For example, what procedures you do or do not want (such as intubation or resuscitation), if you want palliative care for pain, if you do or do not want to be fed by a tube or have an IV, and if you wish to be an organ or tissue donor. A living will lets you decide now what level of care you want in the future and can always be changed or revoked by you.
Durable power of attorney (aka medical power of attorney or DPOA) is another important advance directive to consider. A DPOA names another person to carry out your wishes for you if you can’t. This person works with medical care providers and can make decisions even if a situation is not covered in a living will. This person should be someone you trust, who knows what you want and don’t want, and who is capable of advocating on your behalf.
Perhaps the most fundamental advance directive is a Do Not Resuscitate Order commonly called a DNR. This advance directive dictates whether or not you want to be resuscitated through CPR or an automated external defibrillator and may include use of breathing machines to sustain life. A DNR can also define specific situations where you would or would not want to be resuscitated such as with a terminal illness.
One more option, which is not an advance directive but may be important if you are ill, is a Physician Orders for Life-Sustaining Treatment (or POLST) form which covers your wishes in an emergency. This may be desirable if you are terminally ill and do not want first responders to resuscitate you or take you to the hospital. Since first responders cannot abide by an advance directive, a POLST may be the best choice if they are legal in your state. A POLST form defines exact medical orders and must be signed by a health care provider. Find out more in the polst.com “National POLST: Legislative Guide.”
Who else is protected by an advance directive
Advance directives protect you, but also your loved ones from facing an emergency without knowledge of how you would like to proceed. This can be a heartbreaking situation when family members don’t know or agree on what you would want or if someone important is excluded from decision making such as an unmarried partner who isn’t legally allowed to make decisions on your behalf. Naming someone as the DPOA eliminates these problems and allows medical staff to confer directly with that person to determine care.
Another scenario where an advance directive can provide protection is when life-sustaining decisions must be made quickly and family members are under stress. An advance directive relieves them of making a decision you wouldn’t want and suffering from feelings of guilt afterward. Although advance directives are not legally binding, they are legally recognized and medical care providers will do their best to abide by your wishes. Find out more in the justcareusa.org article, “Six reasons why you and your loved ones should create advance directives.”
To get started with advance directives in Michigan the AARP Michigan “Advance Directives Planning” document is a great resource. For more information about Countryside, please call Margaret Nagel at (517) 206-5000 or download our brochure to learn about our care levels, cost, and amenities.