Wednesday, May 22, 2013

Advanced care directives

Table of Contents

State laws vary regarding living wills. Information specific to individual states usually may be obtained from the state bar association, state medical association, state nursing association, and most hospitals or medical centers.

A living will is not to be confused with a last will and testament that distributes assets after a person's death.

Special medical power of attorney. A legal document that allows an individual to appoint someone else (proxy) to make medical or health care decisions, in the event the individual becomes unable to make or communicate such decisions personally.

NOTE: This document provides for power to make medically related decisions only and does not give any individual power to make legal or financial decisions.

DNR (do not resuscitate) order. This states that CPR (cardiopulmonary resuscitation) is not to be performed if your breathing stops or your heart stops beating. The order may be written by the person's doctor after discussing the issue with the person (if possible), the proxy, or family.

RECOMMENDATIONS

  • In the event you choose to create a living will or special medical power of attorney, know specific state laws that may apply. Write the document to be consistent with your state's laws.
  • If you have a living will or special medical power of attorney, provide copies for your family members and health care providers. Carry a copy with you in a wallet, glove compartment of a car, or similar location. If you have a planned admission to a hospital, take copies for the hospital to include in your medical chart and tell all medical personnel involved with your case about the documents.
  • Consider the possibilities of the future, and plan ahead. Studies have shown that although the majority of people believe having some form of advance directive is a good idea, most people have not actually developed advance directives for themselves. Many people state that they want their families to make health care decisions. However, less than half of these people have ever discussed the issue and their specific desires with family members.
  • These decisions can be changed at any time. However, if a living will is changed, everyone involved -- including family or proxies and all healthcare providers -- must be informed and new copies of instructions made and distributed.

SUMMARY

The process of creating advance care directives may be difficult. It requires you to think about your priorities regarding quality of life and your death. Treatment options, and their possible influence on your quality of life, need to be fully understood and considered. Know the potential implications of choosing or refusing specific forms of care.

Discuss your wishes regarding advance care directives with your health care providers, family members, and friends. Review your wishes from time to time to remind everyone.


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Review Date: 11/17/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)