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What is a Living Will?

What are Advance Directives?

Why is talking about your end of life wishes important?

If talking is so important, why is it so hard?

What is Palliative Care?

How Can Palliative Care Help Me?

Common Misconceptions about Hospice

Medical Terms for End-of-Life

 

 

What are Advance Directives?

Are a written statement of your wishes, preferences and choices regarding end-of-life health care decisions. With an advance directive, you can express how much or how little you want done for you when you are no longer able to make these decisions.

Advance directives are legally valid throughout the United States. While you do not need a lawyer to fill out an advance directive, your advance directive becomes legally valid as soon as you sign them in front of the required witnesses. The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state's law. Also, advance directives can have different titles in different states.

Emergency medical technicians cannot honor living wills or medical powers of attorney. Once emergency personnel have been called, they must do what is necessary to stabilize a person for transfer to a hospital, both from accident sites and from a home or other facility. After a physician fully evaluates the person's condition and determines the underlying conditions, advance directives can be implemented.

One state’s advance directive does not always work in another state. Some states do honor advance directives from another state; others will honor out-of-state advance directives as long as they are similar to the state's own law; and some states do not have an answer to this question. The best solution is if you spend a significant amount of time in more than one state, you should complete the advance directives for all the states you spend a significant amount of time in.

Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one. 

You should review your advance directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advance directive once you have completed it, you should complete a whole new document.

A medical power of attorney (or healthcare proxy) allows you to appoint a person you trust as your healthcare agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf.

Before a medical power of attorney goes into effect a person’s physician must conclude that they are unable to make their own medical decisions. In addition:

  • If a person regains the ability to make decisions, the agent cannot continue to act on the person's behalf.
  • Many states have additional requirements that apply only to decisions about life-sustaining medical treatments.


Why it is important to have Advance Directives

There is great reason to recommend that patients communicate with their physicians and family members about their end-of-life wishes.

This could include telling medical personnel when to maintain life support, when to turn it off, and when not to resuscitate you. If you don’t leave these instructions, someone else will make these decisions for you if you should become incapacitated.

Too often a person with a terminal condition goes into cardiac arrest at home, and the family cannot find the paperwork to relate the person’s wishes to the emergency personnel. This situation frequently results in excessive resuscitation efforts—despite your wishes and desires. Unfortunately, without the legal paperwork, emergency personnel must do everything possible to attempt to revive.

A living will gives you the power to choose how you would like to be cared for in the days leading to your death. It also removes some of the burden from your family when they know that they are following your wishes.

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