Making an advance directive allows you to ensure health care providers and caregivers follow your wishes if you lose the capacity to make decisions yourself. For example, you may be unable to communicate your medical preferences if you're involved in a serious vehicle collision or develop advanced dementia.
These legal documents can outline which treatments you wish to receive in various situations, and you can use them to opt out of invasive treatments such as intubation if you don't want them. Therefore, they can provide peace of mind that you won't undergo painful or uncomfortable procedures against your wishes. You can also use your advance directive to define when and for how long you wish to receive specific treatments.
Advance directives can also help ease pressure on your loved ones if you become seriously ill. Recording your health care wishes reduces the need for relatives to make crucial decisions on your behalf and may minimize disagreements if the views of your loved ones differ.
There are several types of advance directives, and which is suitable for you depends on your relationships and medical preferences. Living wills and medical powers of attorney are the most common types of advance directives.
You can also make "do not resuscitate" and "do not intubate" orders. These advance directives record your wishes about resuscitation and artificial ventilation only, and you don't need a living will or medical power of attorney to create them.
Living wills contain detailed instructions on which medical treatments you want and don't want to receive if you're unable to make or communicate your decisions. You can also detail in which circumstances you want doctors to provide different treatment options. Doctors use these legal documents to determine treatment plans in accordance with your wishes.
The most common treatments and procedures covered in living wills include:
Determining which care aspects to cover and deciding your best options can be challenging if you don't have expert medical knowledge. Your doctor can help you weigh the pros and cons of each treatment decision to help you choose the most appropriate option for your unique circumstances.
Medical power of attorney grants a chosen person the right to make medical decisions on your behalf if you lose decision-making capacity. The legal term for a medical power of attorney varies from state to state. Depending on where you live, you may hear it referred to as a health care proxy, health care power of attorney or health care agent.
If you make an advance directive naming a medical power of attorney, the person's power to make decisions only applies if you lose capacity. They can't make decisions for you if you have capacity, and you can start making decisions for yourself again if you lose capacity and later regain it. For example, your health care agent may make decisions temporarily if you're under general anesthesia. They can't decide about other aspects of your affairs, such as your finances.
Often, people grant a relative or close friend medical power of attorney in conjunction with a living will. If you have a living will, your health care agent must follow your medical wishes using your documented instructions. Otherwise, they must make decisions in your best interests.
You must make an advance directive in writing following the requirements where you live. You don't usually need to hire a lawyer to make one, but you may need to have the form signed by a witness.
To be valid, you must use the form required by your state. The AARP offers free, state-specific advance directive forms for download via its website.
It's wise to keep your advance directive form in a secure location and provide copies to your doctor and any health care agent selected via a medical power of attorney. Many people find it helpful to discuss the contents of their advance directive with friends and loved ones. These conversations can help those around you understand your wishes and may reduce conflict if you become seriously ill.
After making an advance directive, review it if your circumstances change to ensure it still accurately expresses your wishes. For example, you may want to change certain aspects of your directive after a new diagnosis.
