What is an advance directive?
An advance directive is a document that tells your healthcare provider and family what kind of medical care you'd want (or wouldn't want) if you become terminally ill and can't speak for yourself. An advance directive takes effect only if you can't express your wishes (for example, if you're in a coma).
In a living will, one type of advance directive, you tell healthcare providers what kind of treatments you'd want (or refuse to have) if you were dying and unable to speak for yourself or if you become permanently unconscious. For example, you may state that you wouldnwant to be kept alive on a breathing machine if you're unconscious with no hope of recovery.
A living will won't prevent you from getting medical care if you're sick or injured. It simply tells healthcare providers what kind of care you'd want if you couldn't speak for yourself. You can cancel or change these instructions at any time.
A durable power of attorney for healthcare, also called a healthcare proxy or surrogate, is another type of advance directive. You'll use it to name someone you trust to make healthcare decisions for you if you can't speak for yourself. Like a living will, it takes effect only if you can't make medical decisions for yourself. The person you name must be at least 18 years old and usually can't be your doctor or other healthcare provider.
Which type of advance directive do I need?
The American Bar Association recommends that patients have both a living will and a durable power of attorney for healthcare. A living will is more detailed, but it may not cover a medical situation you experience in the future. In that case, having a durable power of attorney for healthcare lets a trusted relative or friend make decisions about a situation or treatment not covered in your living will.
Living wills and durable powers of attorney for healthcare are for everyone, not just older adults. Sudden illness or an accident can happen to anyone.
How can I prepare an advance directive?
Prepare an advance directive when you're well. Discuss your wishes with your family and with anyone you name to make decisions for you, so they'll know what you'd want if you become seriously ill.
Your healthcare provider or local hospital can provide the forms to fill out. If you're admitted to a hospital, you'll be asked if you have an advance directive; if you don't, the hospital can give you the forms you need. For forms and a tool kit, visit the U.S. Living Will Registry's Web site at http://www.uslivingwillregistry.com/forms.shtm and the American Bar Association's Web site at http://www.abanet.org/aging/toolkit/home.html.
You don't need a lawyer to write your advance directive, although you may want one to help you. Follow legal requirements (as outlined on the form) to prepare valid documents and make sure you put the date on your documents. Usually you'll need two people to witness your signature; some states also require that you have your signature notarized.
Make several copies of your advance directive. Keep one for yourself and give others to your healthcare providers, lawyer, family members, and friends. Bring copies of these documents if you're being admitted to a hospital or nursing home. If your wishes change, write new documents and destroy the old ones.