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Sometimes, adults are not able or willing to make decisions for themselves because of a mental or physical condition.
This situation can happen suddenly. That is why it is helpful to have an advance directive.
An advance directive is a written statement of how you want your medical care provided if, in the future, you cannot, or in some cases, do not wish to, make decisions for yourself.
Filling out advance directives gives you control over your future health care.
Serious health care decisions can be hard to make even when people are healthy. But if they are already seriously ill, such decisions can seem overwhelming.
You may change or cancel your advance directive at any time. All you have to do is tell your doctor or give the doctor a copy of the new form. The doctor will make note of the change in your medical record. Also, make sure your family and person who you have designated to make health care decisions know about the change.
Keep a copy of the document with your important personal papers.
In general, there are two main types of advance directives:
Specifics might vary by state and country law.
Living wills and advance care plans allow you to say what kinds of care you would or would not want if you cannot make your wishes known at the time. This plan may also be called a health care directive or health care declaration.
A living will often refers to life-sustaining measures. This means advanced, high-tech care that can keep you alive past the time when you might normally die.
These measures may include:
A medical power of attorney or designation of health care agent allows you to name the person you would like to make health care decisions on your behalf. This person may be called your health care agent, representative, proxy, or attorney-in-fact. Although these names mean the same thing when it comes to health care, each may have different rules or requirements.
If you cannot make your own health care decisions, this person may make those choices for you. The health care agent is usually a relative or close friend.
This type of advance directive may also be called an appointment of health care agent, durable power of attorney for health care, or a health care proxy.
In some states, the document can take effect right away even when you still can speak for yourself. You can make this desire known on the form.
Ideally, these documents should be completed when you are healthy. Making these choices when you are in good health can reduce the burden on you and your loved ones later on.
Yet many people connect filling out advance directives to making decisions near the end of life. But you don’t need to wait until being diagnosed with a serious illness to think about your wishes for care.
It's hard to talk about these issues. But there are benefits to talking to the people close to you about the kind of care you want:
Your attorney or a social worker at your care center can help you locate the proper forms to fill out. State-specific advance directives can be downloaded from the National Hospice and Palliative Care Organization.
Once you have completed them:
Each state has its own laws regarding advance directives. Therefore, special care should be taken to follow the laws of the state where you live or are being treated. A living will or medical power of attorney that is accepted in one state may not be accepted in another state, although many states will accept a proper form from another state.
It is always best to have your advance directive wishes stated in a signed, legal document. If you are not able to appoint a health care agent in writing, you can still tell your doctor who you would want to speak for you should the need arise. In many states, the person you choose is called your surrogate. Your doctor will write the name of the surrogate in your medical chart. In the future, if you are unable to make health care choices for yourself, the medical staff will call on this person to make those decisions if that person is available and willing to make decisions.
Studies show that an advance directive, by itself, often does not answer all the questions that can come up. If something happens to you, your care will depend on your health care agent, your doctor, and your family. The more they know about your wishes, the better job they can do if the need occurs.
Reviewed: March 2019