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Advance Directives

What are advance directives?

Advance directives are legal documents that state your wishes and plans for medical care. These plans are made ahead of time in case you lose your ability to make decisions for yourself. Advance directives can apply to any medical decision, such as the treatments you want, and if you want to donate organs.

What are the types of advance directives?

There are many types of advance directives, and each state has rules about how to use them. You may choose a combination of any of the following:

  • Living will: This is a written record of the treatment you want. You can also choose which treatments you do not want, which to limit, and which to stop at a certain time. This includes surgery, medicine, IV fluid, and tube feedings.

  • Durable power of attorney for healthcare (DPAHC): This is a written record that states who you want to make healthcare choices for you when you are unable to make them for yourself. This person, called a proxy, is usually a family member or a friend. You may choose more than 1 proxy.

  • Do not resuscitate (DNR) order: A DNR order is used in case your heart stops beating or you stop breathing. It is a request not to have certain forms of treatment, such as CPR. A DNR order may be included in other types of advance directives.

  • Medical directive: This covers the care that you want if you are in a coma, near death, or unable to make decisions for yourself. You can list the treatments you want for each condition. Treatment may include pain medicine, surgery, blood transfusions, dialysis, IV or tube feedings, and a ventilator (breathing machine).

  • Values history: This document has questions about your views, beliefs, and how you feel and think about life. This information can help others choose the care that you would choose.

Why are advance directives important?

An advance directive helps you control your care. Although spoken wishes may be used, it is better to have your wishes written down. Spoken wishes can be misunderstood, or not followed. Treatments may be given even if you do not want them. An advance directive may make it easier for your family to make difficult choices about your care.

How do I decide what to put in my advance directives?

  • Make informed decisions: Make sure you fully understand treatments or care you may receive. Think about the benefits and problems your decisions could cause for you or your family. Talk to caregivers if you have concerns or questions before you write down your wishes. You may also want to talk with your religious or spiritual advisor, or a social worker. Check your state laws to make sure that what you put in your advance directive is legal.

  • Sign all forms: Sign and date your advance directive when you have finished. You may also need 2 witnesses to sign the forms. Witnesses cannot be your doctor or his staff, your spouse, heirs or beneficiaries, people you owe money to, or your chosen proxy. Talk to your family, proxy, and caregivers about your advance directive. Give each person a copy, and keep one for yourself in a place you can get to easily. Do not keep it hidden or locked away.

  • Review and revise your plans: You can revise your advance directive at any time, as long as you are able to make decisions. Review your plan every year, and when there are changes in your life, or your health. When you make changes, let your family, proxy, and caregivers know. Give each a new copy.

Where can I find more information?

  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address: http://www.aafp.org
  • National Hospice & Palliative Care Organization (NHPCO)
    1700 Diagonal Road, Ste 625
    Alexandria , VA 22314
    Phone: 1- 703 - 837-1500
    Phone: 1- 800 - 658-8898
    Web Address: http://www.nho.org

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your health condition and treatment options. You must also learn about advance directives and how they are used. Work with your caregivers to decide what care will be used to treat you. You always have the right to refuse treatment.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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