What Is an Advance Healthcare Directive?

No one wants to think about difficult events like illness, accident, or death. They make us uncomfortable, and many of us avoid the subject entirely. But as hard as these conversations are, they are important to have with your loved ones and caregivers now, so that if the time comes, your wishes are clear. That is what an advance healthcare directive is for. Here is what you need to know.

What is an advance healthcare directive?

An advance healthcare directive is a legally binding statement of how you would like to be treated if you become unable to make decisions for yourself. These documents guide doctors and caregivers if you are terminally ill, seriously injured, in a coma, in the late stages of dementia, or near the end of life.

Who should have one?

Advance directives are not just for older adults. Unexpected end-of-life situations can happen at any age, so it is important for every adult to prepare one for use if the unexpected occurs.

What are the main components?

Advance directives vary by state and by individual preference, but in general they include two main parts: the Living Will and the Power of Attorney.

Living Will

A Living Will is a written legal document that outlines your future healthcare decisions if you become unable to make them yourself. It generally takes effect only when a person has a terminal illness or permanent unconsciousness. If you are able to speak on your own behalf, or if there is a chance of recovery, the Living Will is not used, and you may revoke it at any time.

A Living Will deals mainly with life-support treatments, so when creating one it helps to consider the treatments you would or would not want, such as mechanical ventilation, tube feeding, dialysis, and do-not-resuscitate or do-not-intubate orders. Consider your personal values and what situations would matter most to you, then talk with your doctor, your healthcare agent, and your family about your wishes.

Power of Attorney

Similar to a Living Will, a healthcare Power of Attorney (sometimes called a healthcare proxy) applies when you are unable to make decisions on your own, but instead names a person to make those decisions for you. Unlike a Living Will, it can take effect even when the patient does not have a terminal illness or permanent unconsciousness.

Choosing your healthcare Power of Attorney is one of the most important decisions you can make, since this person will have authority over your care when you cannot speak for yourself. Choose someone you trust, who meets your state's requirements, who is not part of your medical care team, who is willing to discuss end-of-life issues with you, and who will honor your wishes and advocate for you. It is also wise to name an alternate in case your first choice becomes unable or unwilling to act.

Why is it important?

Many people do not have an advance healthcare directive, and if the worst happens, their loved ones, already dealing with grief, may not know how to act. By planning ahead, you help ensure you receive the medical care you want, avoid unnecessary suffering, reduce confusion and disagreement, and relieve your family of the burden of making difficult decisions during a crisis.

Talk to your physician, your healthcare providers, and your loved ones today, and make sure that if the time comes, you receive the care you want.

For more on care programs, advance planning, and preventive medicine, MD at Home is a trusted resource for primary care and geriatric medicine for homebound patients in Chicagoland and South Florida.