Advance Directives

What is an advance directive?
You have the right to accept or decline health care. An advance directive is a legal statement. It states your wishes for health care in the event you couldn't make your wishes known. It also can name a person whom you'd want to make decisions for you.

Why get an advance directive?
Without an advance directive, you may not get the health care you DO want.
Without an advance directive, you may get health care you DO NOT want.
Without an advance directive, your loved ones may have to make decisions for you. They may not know your wishes about health care. There may be conflict if your loved ones do not agree with another. An advance directive relieves them of this hardship.

Advance directives do not...

  • Apply if you can make your wishes known.
  • Discuss money or property. They are only for health care choices.
  • Have to be followed if your wishes go against your doctor's morals, the health center's rules, or health care standards.
  • Do not apply to EMS (emergency medical service) workers who respond to 911 calls, unless you have complied with your state's exceptions (see links below).

Types of advance directives
There are two types of advance directives. However, most states merge both types into one statement. The two types of advance directives are:

  • Living wills. A living will states your wishes about the use of certain health treatments at the end of life. Examples include a feeding tube or pain medication. You must have a life-ending illness or be unconscious for the rest of your life for a living will to be followed.

  • Durable power of attorney. In this report, you name a person who will make health care choices for you if needed. You can also note which treatments you do and do not want.

Parts of advance directives

  • Life-sustaining treatment. You can state if you want machines or other support to keep you alive when your body is failing. This may include CPR (cardiopulmonary resuscitation), which restarts your heart with electric shock, chest compressions, or medicine. Other forms of life-sustaining treatment include breathing devices, nutrition and fluids, and machines that do the job of your kidneys.

  • Comfort care. You can state if you want to be given treatment that would make you more comfortable. Such treatment includes pain medication.

  • DNR (Do not resuscitate). You can state if you do not want your heart or lungs to be restarted if they stop working. Some states have two types of DNR—one for inside and one for outside the hospital. The outside-of-hospital DNR is for emergency teams who answer 911 calls. You and your doctor must sign this report.

  • Do not incubate. You can state if you do not want to have devices that help you breathe.

  • Do not hospitalize. You can state if you do not want to go to a hospital. You can stay where you are.

  • Organ and tissue donation. You can state if you want to donate your organs. Even though you have cancer, you may be able to donate your parts of your eyes to others or your whole body for research.

How do I get an advance directive?
You can make an advance directive by telling someone what to write or writing it yourself. Talking with a lawyer may help but is not needed. Visit the websites listed below to get a form to complete for your state. All states accept advance directives, but the rules for advance directives vary between states.

Who should get my advance directive?
Give a copy to your family, doctors, and anyone else who may decide your health care. Keep the original at your house in a place where it can be easily found. You may also want to keep a copy in your wallet. If you make changes, give everyone the new report who has the old copy. In addition to written copies of your advance directives, be sure to speak openly and honestly with your loved ones.  Truthfully answer their questions so that they really understand your wishes.

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