You can decide in advance what medical treatment you want to
receive if you become physically or mentally unable to communicate
your wishes. As an adult in a hospital, skilled nursing facility,
or other health care setting, you have the right to (a) keep
your personal and medical records private, (b) know what kind
of medical treatment you will receive and (c) tell people ahead
of time what type of treatment you want, or don't want, in case
you lose the ability to speak for yourself. You can do this
by preparing an Advance Directive.
What is an Advance Directive?
Generally, an Advance Directive is a written document that
tells people how to make your medical decisions when you can't
make them for yourself. An Advance Directive can also designate
someone else to make medical decisions for you. Two common
Advance Directives are a Living Will and a Durable Power of
Attorney For Health Care.
A Durable Power of Attorney for Health Care is a signed,
dated, and witnessed paper that authorizes someone else to
make your medical decisions if you are unable to make them
for yourself. This can include instructions about any treatment
you want to avoid. It is also commonly called a Health Care
Proxy.When choosing your agent, make sure he or she knows
your wishes, values and preferences. If you use a form document,
do not just sign it -- read it carefully and tailor it so
that it clearly expresses your values and wishes. An important
question to ask yourself is: "Do you want food and fluids
withheld under any circumstances?"
A Living Will is a written document that generally states
the kind of medical care you want (or do not want) in case
you become unable to make your own decisions. It's called
a Living Will because it takes effect while you are still
living. While most States have their own Living Will forms,
you might also be able to write a personal statement of your
preferences for treatment. A Living Will differs from a Durable
Power of Attorney for Health Care in that a Living Will does
not appoint an agent and, in many States, applies only to
terminal illness or persistent vegetative state.
Because the Living Will applies only in narrowly and sometimes
unclearly defined circumstances, it is best to have both a
Living Will and a Durable Power of Attorney for Health Care
or to combine them both in one advance Directive. Your Advance
Directives should be part of your medical record.
Which is Better: A Living Will or a Durable Power of Attorney
for Health Care?
In some states, laws may make it better to have one, the
other, or both. The decision is up to you. But remember, a
Living Will doesn't allow you to name someone to make your
medical decisions, if that is what you want. Check with your
attorney or you may want to consult the State Attorney General
offices.
Federal law requires hospitals, skilled nursing facilities,
hospices, home health agencies and managed care plans to give
their patients who are covered by Medicare or Medicaid information
about Advance Directives. The law is intended to increase
your control over medical treatment decisions. However, health
care providers only have to provide information about the
laws for the State in which they are located. Laws governing
Advance Directives differ from State to State. Also, the laws
on honoring Advance Directives from one State to another aren't
clear. If you live in one State, but travel to other States
frequently, you may want to consider having your Advance Directive
meet the laws of other States. A good source of information
is the Office of the State Attorney General.
Points to Consider
1. You don't have to have and Advance Directive if you don't
want one.
2. If you have an Advance Directive:
Tell your family. Make sure they know where it is located;
Tell your lawyer. Tell you Doctor. Make sure the Advance Directive
is part of your medical records. If you have a Durable Power
of Attorney, give a copy of the original to that person. Keep
a small card in your purse or wallet that notifies Emergency
Medical Services (EMS) providers of your wishes. (EMS generally
refers to ambulance companies and paramedics). However, in
an emergency situation, EMS staff don't have much time to
look for, or to evaluate different types of documentation.
They may only acknowledge cards issued by the State's EMS
Program, and only when the cards are signed by your personal
physician.
Canceling an Advance Directive
You may change or cancel your Advance Directive at any time.
Any change or cancellation should be written, signed, and
dated. Give copies to your doctor and to anyone else to whom
you may have given copies of the original. Some States allow
you to change an Advance Directive by oral statement. To check
the laws that apply to your State, contact your State Attorney
General.
If you want to cancel an Advance Directive while you are
in the hospital, notify your doctor, your family, and others
who may need to know. Even without a change in writing, telling
your doctor directly about your wishes generally will carry
more weight than a Living Will or Durable Power of Attorney
as long as you can decide and communicate for yourself.
For Additional Information
Preparing an Advance Directive lets your physician and other
health care providers know the kind of medical care you want,
or don't want, if you become incapacitated. It also relieves
your family and friends of the responsibility of making decisions
regarding life-prolonging actions.
For more information on Advanced Directives call your local
Geriatric Care Manager who is a certified Advanced Directive
counselor or you clinic or hospital.
Sheri D. Fanning,RN,C CareMate: Elder Care Planning Services
400 South Water Street Sparta, WI 54656 608-269-5888 phone
608-269-1837 fax sheri@caremate.com
www.caremate.com
Source: Health Care Financing Administration
