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End of Life Decisions: Advance Directives
 - What are Advanced Directives?
"Advanced
directives" are legal documents that allow you to plan and make known your end-of-life wishes in the event that you are
unable to communicate. Advanced directives consist of(1) a living will (2) a medical power of attorney. A living
will describes your wishes regarding medical care. With a medical power of attorney you can appoint a person to make
health care decisions for you in case you are unable to speak for yourself.
- What is a Living Will?
A living will is an advance directive
that guides your family and health care team about the medical treatment you wish to receive if you are unable to communicate
your wishes. According to your states living will law, this document is considered legal as soon as you sign it and
a witness signs it, if that is required. A living will goes into effect when you are no longer able to make your own
decisions.
- What is a Medical Power Of Attorney?
A Medical Power of Attorney is the advance directive where you select a person you trust to make decisions
about your medical care if you are temporarily or permanently unable to communicate and make decisions for yourself.
This includes not only decisions at the end of your life, but also in other medical situations. This document is also
known as a "health care proxy," "appointment of a health care agent" or "durable power of attorney
for health care." This document goes into effect when your physician declares that you are unable to make
your own medical decisions. The person you select can also be known as a health care agent, surrogate, attorney-in-fact
or health care proxy.
- What is a CPR (Cardio Pulmonary Resuscitation) Directive?
A CPR Directive allows you, your agent,guardian or proxy to refuse resuscitation.
CPR is an attempt to revive someone whose heart and/or breathing has stopped by using special drugs and/or machines or very
firm pressing on the chest.
If you have a CPR Directive and your heart or lungs stop or malfunction, then paramedics
and doctors, emergency personnel or others will not try to press on your chest or use breathing tubes,electric shock or other
procedures to get your heart or lungs working again.
- Who should I select to be my Medical Power of Attorney?
You should select someone you trust, such as, a close family member or good friend that understands your wishes
and feels comfortable making health care decisions for you. You should have ongoing conversations with this person to
talk about your wishes at the end of life. Make sure your medical power of attorney feels comfortable and confident
about the type of medical care you want to receive.
It is essential that you fully discuss your wishes about treatment
in case of losing cognitive function or falling into an irreversible comma. Most state laws prevent your doctor or any
professional caregiver from being assigned as your health care agent. You can also select a second agent as an alternate
in case your first health care agent is unwilling or unable to serve.
- How can I prepare my Advance Directives?
You can
fill out both a living will and a medical power of attorney form without a lawyer. The National Hospice and Palliative
Care Organization, your state hospice organization, local hospitals, public health departments, state bar associations or
state aging offices provide state specific forms and instructions. It is very important that you use advance directive
forms specifically created for your state so that they are legal. Read the forms carefully and make sure you follow
the legal requirements determined by your state. You may need to have a witness signature and get the forms "notarized"
(signed by a notary public).
Keep your completed advanced directives in an easy to get to place and give photo
copies to your primary medical power of attorney and your secondary, alternate agent. This document stays in effect
until you cancel it or decide to complete a new one with changes.
- Can health care professionals refuse to honor my Advance Directives?
Some health care professionals may choose to ignore what is written in your living will if they believe what is written
is against your best interest or for moral or religious reasons. In some cases there may be a misunderstanding of the
law, medical ethics or professional responsibilities. It is important for you to know if your doctor will honor your
request. If not, you may need to choose another doctor who will honor your request. Bring your completed living
will to your next health care appointment and ask your doctor if he/she has questions or concerns.
- Who would decide about my medical care if I did not complete
Advanced Directives?
If you are unable to make decisions, health care professionals must consult your
family members. Some states have decision making laws to identify individuals who may make decisions on your behalf
when you do not have advanced directives such as your spouse, parents or adult children.
- Do Advanced Directives include my wishes about organ donation, cremation, or burial?
Some states may include your wishes about whether you want to be an organ donor as part of the Advanced Directives.
If not included, you can still write down your decision about organ donation. However, you should fill out a specific
form for that purpose.
You should also let your loved ones know if you wish to be buried or cremated.
If you have any questions about Advanced Directives you can call Family Hospice directly at 303-440-0205
and we will be glad to help you obtain the necessary forms and answer any questions or concerns.
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