An Advance Health Care Directive, also called an Advance Directive, is an estate planning document that allows you to name another individual – your Health Care Agent – to make medical decisions for you, and allows you to document your medical care preferences in the event you are incapacitated, heavily medicated, or simply unable to communicate with your doctors for any reason.
What Exactly Is an Advance Directive?
This is a very personal document as it also outlines directions about termination of life support in the event of an irreversible vegetative state, and gives instructions about organ donation or burial/cremation. This is a document that is used when you are in your most vulnerable state – as such, it should be carefully crafted to express that which you feel strongly about in terms of medical decisions and end-of-life decisions, and should be fully customized to effectively relay your wishes to your doctors and your family.
What Kind of Medical Decisions Can an Advance Directive Cover?
Your Health Care Agent will be able to access your medical records, communicate with your doctors, sign Consents to Treatment, Refusal to Permit Treatment, admit you or release you from a hospital, place you in a care facility, authorize pain relief, make life-and-death decisions (or, life support decisions), authorize an autopsy, organ donation (per your wishes), obtain death certificates, and arrange for the disposition of your remains by way of a cremation or burial (as you instruct in the document).
An Advance Directive is not a DNR
A “Do Not Resuscitate” (or DNR) Directive prevents medical staff from using CPR to save someone's life if their heart stops beating. It has a very narrow scope, and it is a separate document from an Advance Health Care Directive. Its provisions are not contained in the Advance Directive.
How Is an Advance Directive Different from a Living Will or Medical Power of Attorney?
An Advance Directive combines the provisions of a Living Will (which is a directive about end-of-life decisions) and Medical Power of Attorney into a single document.
What about an Advance Dementia Directive?
A Voluntary Advance Directive for Receiving Oral Feedings and Fluids in the event of advanced dementia has a very narrow focus applicable only during advanced stage of Alzheimer's” - stage 6 or 7 (moderate to severe) of the Functional Assessment Staging Tool (“FAST”) which includes severe cognitive decline and the need for extensive assistance for most activities of daily living including toileting and eating. This document instructs against force-feeding, personal comfort, and palliative care. This is an additional document that – if desired - be prepared to supplement your Health Directive.
Why Do I Need an Advance Directive?
You should have an advance directive because it can answer important questions about your medical care wishes during times when you are unable to communicate with doctors or medical staff on your own.
Contrary to what many people believe, family members are not able to make medical decisions for their loved ones without first having the legal authority to do so. In the absence of a Health Care Directive, should one become incapacitated, his/her family would need to file for a Conservatorship and have a family member appointed by the Court as a Conservator of the Person before they will have the authority to make medical decisions for the incapacitated adult. A Conservatorship is a lengthy, invasive and expensive court process – that can be completely made unnecessary if a person signs his/her Health Care Directive.
Parents of children who turn 18 should remember that their child becomes an Adult on their 18th birthday – which means that parents will no longer be given any medical information about their children, even if a child has been in an accident and taken to an emergency room. Parents of young adults should make it a priority to have their teens sign an Advance Health Care Directive to permit the parent to remain legally in-the-know and involved in the health of their child, especially when children leave home to go to College.
Does My Doctor Have to Follow My Advance Directive?
Yes, although there are some very rare exceptions when a directive conflicts with State or Federal laws, or accepted health care standards. Should a doctor or hospital reject your preference for medical care, your Agent can change your doctors, or transfer you to a medical care provider who is able to honor your decisions, to the extent permitted by law.
Does My Health Care Agent Have to Follow My Individual Healthcare Instructions?
Yes, to the extent that you've stated your instructions. Your health care agent can make decisions for you that you didn't anticipate or intentionally left undecided, but they can't override your Individual Healthcare Instructions.
When Can I Start Creating My Advance Directive?
If you'd like to crate your Advance Directive, the Law Offices of Maria N. Jonsson, PC can help you get started. Since this is a legal document that tackles life-and-death decisions, having an attorney guide you through this process can be important to ensure your Advance Directive is fully customized to your specific wishes.
Contact us online now to request an attorney consultation!