Understanding Advance Directives

Advance Directives are legal documents that guide medical and health care decisions in the event that a person becomes incapacitated and is unable to make their own decisions.

Advance directives, sometimes called “living wills,” protect individuals if they are unable to make decisions regarding their health or end-of-life care.

There are many reasons why an adult may be unable to make their own medical and health care decisions. Disease processes such as Dementia or Alzheimer’s affect one’s ability to comprehend and make informed and independent decisions. Traumatic accidents or unexpected illnesses can lead to a comatose state or affect the brain’s ability to function. In both cases, you wouldn’t be able to be involved in decisions regarding your care. Even those who have lived a long and healthy life may find themselves unable to communicate effectively or comprehend during their final hours of life. In all of these instances, an advance directive is crucial to ensure that your wishes are respected and that you only receive the life-sustaining measures and the level of treatment you prefer. A life-threatening illness or accident can occur at any age, so everyone over the age of 18 should have an advance directive.

Parts of an Advance Directive

There are two main parts to an advanced directive. These either dictate specific health care instructions or appoint another individual to make the decisions on your behalf if needed. Both elements are equally important to have in place.

Living will

A living will is a legal document that states what medical care, treatments, or life-sustaining measures you would or would not want if in a vegetative state or terminal condition. A terminal condition is the advanced stage of an irreversible or incurable medical condition that will result in death despite continued medical treatment.

Resuscitation status is one of the most addressed instructions in a living will. This allows the individual to specify if they would like to be resuscitated or be a DNR (Do Not Resuscitate). They can also specify what means of resuscitation are okay. For example, someone may want CPR performed, but they do not wish to be mechanically ventilated. Other common instructions provided in a living will include measures such as blood transfusions, tube feedings, surgical interventions, and organ donation.

Health Care Power of Attorney or Health Surrogate Designation

A power of attorney, or health care proxy, is a legal document. This document allows you to designate a trusted individual, to make decisions on your behalf.

A power of attorney has more decision-making power than a living will. Typically, a living will only applies to the end of life or terminal conditions. A power of attorney can be used if an individual can no longer make informed decisions by themselves, regardless of their medical state. The individual you appoint as power of attorney can make decisions regarding medications, procedures, diagnostic exams, surgical interventions, long-term care management, end-of-life care matters, and more.

Most people appoint their spouse or child as a power of attorney. However, anyone, relative or not, can be appointed. The most important aspect of choosing this individual is trust. Choosing someone who respects your wishes and always keeps your best interest in mind when making decisions is imperative.

Creating (or updating) Advance Directives

There are many factors to consider, whether you need to create a new advanced directive or have an existing one. Something to keep in mind is that advance directives do not expire. Because of this, it is a good idea to review your advance directive every few years. This will help ensure that your wishes have not changed over time and that your health care proxy is still willing and capable of making decisions. Updates can be made to existing advance directives, or new ones can be implemented.

It’s also important to note that different legal factors can affect the validity of advance directives. For example, advance directives vary from state to state. This can be confusing because your state’s directive may not be valid in another state. When creating your advanced directive, it is extremely important to understand critical details. We highly recommend that you seek legal guidance from an estate planning or elder law attorney when doing so.

We hope you found this article helpful. If you have questions or would like to discuss your legal matters, please do not hesitate to contact our office at 215-364-1111 to schedule a consultation.