Every adult needs advance directives. Unexpected events can render a person unable to make decisions about his or her medical care at any age.
“Ever since Congress passed the Patient Self-Determination Act in 1990, health professionals and consumer advocates have urged Americans, especially older adults, to draw up advance directives and distribute them to families and doctors.” [1]
Living wills and other advanced directives provide instructions to medical professionals and loved ones.
“By planning ahead, you can get the medical care you want, avoid unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf.”[2]
Living Wills
A living will is a written legal document that specifies what medical treatments you want and don’t want used to keep you alive, along with your preferences for other treatments like pain management or organ donation. It covers things like CPR; ventilators; feeding tubes; organ, tissue, and body donation; dialysis; and comfort care.
Do Not Resuscitate/Do Not Intubate Orders
These tell medical personnel that you do not want heroic measures like CPR used to save your life and that you do not want a breathing tube placed. You do not need a living will or advance directive for DNR/DNI orders. Tell your doctor, and he or she will make them a part of your medical record. Even if you have these in place with your doctor, make new ones any time you are admitted to a new medical facility.
Healthcare Powers of Attorney
Healthcare (medical) powers of attorney allow you to choose a person to make healthcare decisions for you. This person could be called upon to make judgment calls on your behalf, so choose someone you know you can trust to advocate for you if disagreements about your care arise. You can choose a spouse, a family member, a friend, or a member of your church.
You can change or revoke your advance directives at any time. Some scenarios that should prompt at least a review include a new diagnosis, a change in marital status, and a review every ten years.
Advance directives are not legally binding “ A doctor or institution can refuse to honor your advance directives for moral or religious reasons or if the care you request is not medically appropriate.” Talk with your doctor ahead of time to avoid this situation.[3]
Each state has different forms for advance directives, and you don’t need a lawyer to create them. You will need at least two witnesses in most states.
Don’t leave decisions about your healthcare up for debate. Draw up advance directives and make them available to your medical team and the people you trust to advocate for you, no matter your age.
[1] https://www.nytimes.com/2015/03/17/health/the-trouble-with-advance-directives.html#
[2] https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303
[3] https://jamanetwork.com/journals/jama/fullarticle/2130319