Advance Medical Directives

The Living Will
Durable Health Care Power of Attorney
Do Not Resuscitate Order (DNR)
Guardians
Where do you live?
As a Home Care Patient
Who should you ask for additional information about Advance Medical Directives

In the United States, you have certain rights regarding personal health care decisions. Under normal, non-emergency conditions, you have the right to consent to or refuse any medical care or treatment. But in an emergency situation, when you may not be able to communicate, your acceptance of medical treatment is assumed. Advance Medical Directives are legal documents which inform your family, loved ones, and health care providers of your wishes regarding the withholding of medical treatment when you cannot communicate.

The Living Will
The Living Will is a written set of instructions directing the discontinuance or withholding of medical treatment if there is no rational medical expectation of your recovery. Living Wills are limited to directions concerning medical treatment in the event of a terminal condition. If you have a terminal condition a living will can be used to communicate your wishes regarding medical care should you become unable to communicate. Depending on the state where you live, two witnesses are usually required to sign your living will. Certain people may not act as witnesses such as other patients in the facility where you are receiving care, or people to whom you owe money, or anyone who may inherit your money or property. You can revoke your Living Will at any time verbally or by signing a statement that you no longer wish to abide by your previous directions. Any time you change your mind about your Living Will, it is a good idea to tell your family and friends about it.

Durable Health Care Power of Attorney
Durable Health Care Power of Attorney is also known as a Medical Power of Attorney or a Health Care Proxy. The Durable Health Care Power of Attorney is a set of written instructions naming an agent to make medical decisions for you if you are unable to communicate. The Durable Health Care Power of Attorney applies to all medical decisions unless you decide to include limitations. The Durable Health Care Power of Attorney is more flexible than a living will, as your agent will be able to make decisions based on the situation and is not limited by your previous directives. Durable Health Care Power of Attorney can cover more situations than a Living Will and are not limited to terminal illness. Anyone willing to serve as your health care agent must be at least 18 years old and mentally competent. Durable Health Care Power of Attorney may be canceled at any time.

Do Not Resuscitate Order (DNR)
A Do Not Resuscitate Order (DNR) is usually stated as part of a Durable Health Care Power of Attorney or a Living Will. It can also be stated as part of a Cardio Pulmonary Resuscitation Directive or it can exist on its own. A DNR communicates to emergency health care providers that you do not want to be resuscitated should you go into cardiac or respiratory arrest. Without a DNR, attempts will automatically be made to revive you should the need arise. If you choose to have a DNR, you should keep a copy with you at all times and be sure to inform your friends and family of your wishes. In some states, individuals are allowed to wear an identification bracelet or necklace indicating the existence of a DNR.

Guardians
If a person cannot make personal decisions or lacks sufficient understanding or the capacity to communicate, a guardian may be appointed by the court. An individual may be assigned a guardian if they are mentally impaired as a result of mental or physical illness, retardation, or age-related dementia. A person who receives guardianship is called a "ward". Individuals who serve as guardians must be 18 years of age and willing to serve as guardian. Guardians are not required to live with or financially support their wards, nor are they responsible for their ward's behavior. A court may order the guardian to make medical care and treatment decisions for their ward, and guardians usually decide where a ward should live and who will provide necessary care.

Where do you live?
Some states require specific forms for Advance Directives, while other states allow you to use your own written statements. In order to find out what is required and accepted in the state where you live, ask your doctor, hospital, or attorney. If you move to a new state, you will need to update your Advance Directives to ensure they meet that state's requirements. If you travel frequently, you might want to take copies of your Advance Directives with you.

As a Home Care Patient
In most states you have the right to have honored, by all health care personnel, a personal Advance Medical Directive such as a Living Will or Durable Power of Attorney. Your home care company will determine, at the time of admission, if any standing orders relative to Advance Directives are to be observed. It is the responsibility of your home care company to provide you with written information explaining whether they will or will not comply with your Advance Directive. If the policy of your home care provider goes contrary to your wishes, you have the right to choose another home care provider without fear of repercussion. You should be sure to notify your home care provider and your physician if there are any changes or modifications to your wishes.

Who should you ask for additional information about Advance Medical Directives
The best person to ask for information regarding Advance Medical Directives is your attorney. But using an attorney is not required. You can also ask or get assistance from your doctor, clergy, or from your hospital's social work department. And you should always involve members of your family when making any health care decisions.

To find out which of these Advance Directives are recognized by the laws of your state, ask your doctor, hospital, or attorney. If you wish to prepare an Advance Directive, you should do so before you become to ill to think or communicate clearly. And remember, you do not need to have an Advance Directive in order to receive medical care and treatment, for that will occur automatically. Rather, Advance Medical Directives are usually used to communicate your wishes regarding the withholding or removal of medical treatment.