Advance Directives

Living wills and other advance directives describe your preferences regarding  end-of-life care. Unexpected situations can happen at any age. All adults need advance directives.

Living wills and other advance directives describe your preferences regarding treatment if you're faced with a serious accident or illness. These legal documents speak for you when you're not able to speak for yourself — for instance, if you're in a coma. Advance directives are written instructions regarding your medical care preferences. Your family and doctors will consult your advance directives if you're unable to make your own health care decisions. Having written instructions can help reduce confusion or disagreement.


Living wills and other 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 have advance directives.


Share your wishes with your family

Injury, illness and death aren't easy subjects to talk about, but by planning ahead you can ensure that you receive the type of medical care you want. You also relieve your family of the burden of trying to guess what you'd want done. Be sure to discuss your wishes with your loved ones. Let them know you're creating advance directives and explain your feelings about medical care and what you'd want done in specific instances.


Advance directives include:


Living will. This written, legal document spells out the types of medical treatments and life-sustaining measures you want and don't want, such as mechanical breathing (respiration and ventilation), tube feeding or resuscitation. In some states, living wills may  be called health care declarations or health care directives.


In determining your wishes, think about your values, such as the importance to you of being independent and self-sufficient, and what you feel would make your life not worth living.


Although you can't predict what medical situations will arise, be sure to discuss the following treatments. It may help to talk with your doctor about these, especially if you have questions.


Resuscitation. Restarts the heart when it has stopped beating (cardiac death). Determine if and when you would want to be resuscitated by cardiopulmonary resuscitation (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 do so. Consider if, when and for how long you would want to be placed on a mechanical ventilator.


Nutritional and hydration assistance. Supplies the body with nutrients and fluids intravenously or via a tube in the stomach. Decide if, when and for how long you would want to be fed in this manner.


Dialysis. Removes waste from your blood and manages fluid levels if your kidneys no longer function. Determine if, when and for how long you would want to receive this treatment.


Medical or health care power of attorney. The medical power of attorney is a legal document that designates an individual — referred to as your health care agent or proxy — to make medical decisions for you in the event that you're unable to do so, not just at the end of life. However, it is different from a power of attorney authorizing someone to make financial transactions for you.

 

Choosing a person to act as your health care agent is possibly the most important part of your planning. You need to trust that this person has your interests at heart, understands your wishes and will act accordingly. Don't pick someone out of feelings of guilt or obligation.


Your health care agent doesn't necessarily have to be a family member. You may want your health care decision maker to be different from the person you choose to handle your financial matters. It may be helpful, but it's not necessary, if the person lives in the same city or state as you do.


If you have previously executed any of these documents, you should promptly notify the hospital and provide a copy that can be scanned and made a part of your medical record.


Review your advance directives from time to time

As your health changes or your perspective on life changes, you might reconsider some of your advance directives. Read over your advance directives from time to time to see if you want to revise any of the instructions. You can change your mind about your advance directives at any time.


To revise your advance directives, you follow the same steps you used to create them. Get new advance directive forms to fill out. Discuss your changes with your friends, family and doctor. Then distribute copies of the new advance directives and ask everyone to destroy the earlier version.


If there isn't time to redo the paperwork, you can always cancel your advance directive by telling your doctor and your family.


Remember, a living will or medical power of attorney goes into effect only if you are unable to make medical decisions for yourself, as determined by your doctors.


If you have not executed an Advance Directive

If you have not done so, we urge you to discuss this issue with your physician, family and clergy so that your desires for treatment are clearly understood by all.


A sample Advance Directive form will be provide upon admission; however, you may want to consult with your attorney to have a document drafted to meet your specific needs.


Springhill Medical Center is committed to providing the best possible healthcare to all patients, regardless of their wishes regarding life support or advance directive.




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