How Much Do You Know About Advance Directives?
How important is it to draw up a living will? Take this quiz and find out.
1. The two most common forms of advance directives are the living will and durable power of attorney.
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A regular will is a document that states how you want your estate handled after your death, according to the National Hospice and Palliative Care Organization (NHPCO). It takes effect after you die. A living will is a document that states what kind of medical care you want (feeding tubes or artificial breathing, for example) if you are too ill to make that decision. It does not become effective unless you are terminally ill, with no chance of recovery, and it does not allow you to name someone to make medical decisions for you. A durable power of attorney is another kind of advance directive, in which you name a person who will make medical decisions for you if you are unable to make them yourself. A third kind of advance directive is a do not resuscitate order, which means you do not want medical staff to try to revive you if your heart stops beating or if you stop breathing.
2. A person who has medical power of attorney must be a lawyer.
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The person can be anyone you choose—spouse, son, daughter or friend. The person does not have to be a lawyer. The durable power of attorney document—also called a health care proxy or health care surrogate—can include specific instructions about medical treatment you want or don't want, the NHPCO says. This document is valid indefinitely, unless it lists a specific termination date, is revoked by you or the person you designate becomes incompetent. The person you select can only make health care decisions on your behalf if your doctor declares you incompetent.
3. The person you select to have medical power of attorney is permitted to grant consent for any procedure or treatment.
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In addition to any restrictions you may place on the person with medical power of attorney, in general this person is not allowed to grant consent to have you committed to a mental institution or to allow convulsive treatment, psychosurgery or abortion. The person also cannot consent to allow your comfort to be neglected.
4. Some states require all residents to have an advance directive.
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No state requires an advance directive. It is your decision to have one.
5. Once an advance directive has been signed, it cannot be changed.
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Just as a regular will can be changed, an advance directive can be modified or even canceled, if you change your mind. Appropriate state law must be followed, and you should give copies of the new document to your doctor and others to whom you gave the original paperwork. If you're in the hospital and you don't have time to make the changes in writing, you can make changes by telling your health care provider directly. Make sure to tell your health care provider exactly what you want to happen. Usually, wishes that are made in person will be followed in place of the ones made earlier in writing. To change your advance directive, whether in writing or by telling your health care team and family, you must be of "sound mind," which means you must be able to think rationally and speak clearly.
6. Advance directives are valid only in the state where they are signed.
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If you travel to or vacation in another state, you do not need a separate advance directive for that state. If you move, however, you should prepare a new advance directive to meet the laws of the new state. If you spend a lot of time in another state, you should consider getting a second advance directive so that you are on record in both places.
7. If you have an advance directive, you should keep a small card in your wallet or purse stating that you have one.
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The card should also state where the advance directive is located and the name of the person who will act on your behalf, if you have named one. You should give copies of your advance directive to your health care provider, hospital, nursing facility and person acting on your behalf. You should let your lawyer or a family member know you have an advance directive and where it is located. Keep it in a safe but easily accessible place. You can also keep your advance directive on file at the U.S. Living Will Registry website
(http://www.uslivingwillregistry.com/). Registration is free, and the information is accessible only to health care providers.
8. You need a special form to write an advance directive.
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You can write your own, but special forms may make the task easier. Keep in mind that each state has its own requirements about advance directives. You can obtain a copy of the form for your state from the NHPCO website
(www.partnershipforcaring.org). If you don't use one of those forms, you can use a form provided by your health care provider; obtain a form from your state senator's or representative's office; have your lawyer draw up a form; use computer software for legal documents; or simply write down your wishes by yourself. If you do it yourself, it's a good idea to have your health care provider or lawyer review the document to make sure it meets your state's requirements.
9. It's best to wait until you are in the hospital before preparing an advance directive.
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If you wait until you are hospitalized for an illness, you may become too ill to complete an advance directive. And that's when it's most important to have one. The best time to prepare an advance directive is when you are healthy and able to think through what care you want—or don't want.
10. Your advance directive should use vague wording because you won't know exactly what kind of medical situations you may face.
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Standard advance directive forms do use vague wording, stating only that you would not want "heroic" or "artificial" treatment if you are clearly "dying." It's best to provide as much specific information as possible about the care you want or don't want. Discuss with your health care provider and family different medical situations and what you want to happen. If you don't want artificial resuscitation or if you don't want be put on a ventilator, for example, put that on the form. Although these issues may be uncomfortable or difficult to think about, your answers will help guide your family and caregivers.
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